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Randomised controlled trial
For pregnant women near full term with intrauterine growth restriction, induction of labour does not affect risk of adverse neonatal outcome or caesarean section compared with expectant management
  1. Janet Hirst
  1. School of Healthcare, University of Leeds, West Yorkshire, UK
  1. Correspondence to Janet Hirst
    School of Healthcare, Baines Wing, University of Leeds, Leeds, West Yorkshire LS2 9UT, UK; j.hirst{at}leeds.ac.uk

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Implications for practice and research

  • No differences were found in relation to adverse neonatal outcomes, the rates of instrumental vaginal delivery or caesarean section for women with suspected intrauterine growth restriction (IUGR) who were induced and those who were managed expectantly.

  • These results suggest that women with suspected IUGR should be given the choice of the two care options.

  • As this is the first randomised controlled trial in this area, further studies are required to confirm the findings.

  • Further research is also needed to determine the most effective way of identifying IUGR.

Context

This study focused on pregnant women with a singleton fetus suspected of IUGR (failure to reach growth potential) between 36 and 41 weeks gestation. Comparisons between two forms of care, induction of labour versus expectant management with enhanced antenatal care, were needed to support obstetrician's decision making regarding mode of delivery1 and inform women's choice towards mode of birthing. IUGR is associated with serious intrapartum and neonatal complications.2 3 Growth restriction is attributed to 1–2% …

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