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Term fetuses weighing ≥4000 g (≥90th percentile for gestational age) are at risk for birth complications arising from shoulder dystocia. In a large European trial, researchers evaluated birth outcomes of pregnancies between 37 weeks and 38 weeks plus 6 days in which the fetus was judged to be large for gestation age (≥95th percentile) based on antepartum physical and ultrasound examination. Women were randomized to induction of labor (IOL) with oxytocin or to expectant management (EM), which involved waiting for spontaneous labor. Eight hundred twenty-two women completed the study protocol.
Mean time from randomization to delivery was 4.9 days for the IOL group and 15.4 days for the EM group. Mean neonatal birth weights in the IOL and EM gro…