Does Early Induction of Labor Lower Risk for Shoulder Dystocia in Fetuses That Are Large for Gestational Age?

Shoulder dystocia is a childbirth emergency that requires urgent obstetric interventions to prevent maternal and neonatal morbidity and mortality. To examine whether early labor induction for suspected large-for-gestational-age fetuses lowers these risks, British researchers enrolled 2900 women with fetuses with estimated weight >90th percentile on ultrasound between 35 and 38 weeks' gestation and randomized them to either early induction of labor (i.e., at 38 weeks to 38 weeks and 4 days) or standard care. Important exclusion criteria included gestational diabetes, medication-treated diabetes, and planned induction or cesarean section.

The trial was terminated early due to lower-than-expected rates of shoulder dystocia in the standard-care …