Post Term, What Is the Best Timing for Delivery?

To help determine the optimal timing of postterm induction, Swedish investigators randomized 2760 women (mean age, 31; 55% nulliparous) with low-risk singleton pregnancies at 41 weeks' gestation to induction at 41 weeks or expectant management with induction at 42 weeks. The primary outcome was a composite of adverse perinatal outcomes such as stillbirth, Apgar score <7 at 5 minutes, intracranial hemorrhage, mechanical ventilation within 72 hours, or brachial plexus injury.

Incidence of the primary outcome was similar in the induction and the expectant management groups (2.4% and 2.2%, respectively). However, there were fewer perinatal deaths in the induction group (none) than the expectant management group (5 stillbirths, 1 early neonatal d…