Intrauterine Growth Restriction at Term: Labor Induction or Watchful Waiting?

For fetal safety, many practitioners opt to induce labor when intrauterine growth restriction (IUGR) occurs at or near term. To assess outcomes of labor induction versus expectant management for IUGR, Dutch researchers randomized 650 women with singleton pregnancies beyond 36 weeks' gestation and suspected IUGR to induction within 48 hours or strict monitoring (e.g., daily assessment of fetal movement, twice-weekly heart rate tracings and ultrasound examinations) until onset of spontaneous labor. IUGR criteria included any or all of the following: fetal abdominal circumference or estimated fetal weight less than 10th percentile and third-trimester flattening of growth curves. Fetuses with abnormal as well as normal Doppler flow velocities w…