Labor Induction at 41+0 Gestational Weeks or Expectant Management for the Nulliparous Woman: The Finnish Randomized Controlled Multicenter Trial

( Acta Obstet Gynecol Scand . 2024;103:505–511. doi:10.1111/aogs14755) Post-term deliveries increase risks to both mothers and neonates, increasing further with greater gestational age. Recent studies show that labor induction (IOL) at 41 weeks’ gestation or earlier would decrease complication rates without increasing cesarean deliveries (CD) or other costs associated with delivery. In Finland, current guidelines recommend IOL between 41 weeks and 5 days and 42 weeks and 1 day of gestation for healthy pregnancies. Reasons for this include the negative effects of induced labor and allowing the maximum amount of time for spontaneous labor to occur. This study was designed to assess the most beneficial timing of IOL in nulliparous late-term and post-term gestations with a closed cervix, comparing IOL at 41 weeks and 0 days with expectant management and induction at the recommended gestational age. It was hypothesized that earlier IOL would reduce adverse labor outcomes and decrease CD rates.