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  • Induction of labour at 37–38 weeks in women with large fetuses decreases the likelihood of shoulder dystocia; however, overall benefit of early-term delivery has not been demonstrated

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Therapeutics/Prevention
Randomised controlled trial
Induction of labour at 37–38 weeks in women with large fetuses decreases the likelihood of shoulder dystocia; however, overall benefit of early-term delivery has not been demonstrated
  1. Lawrence M Leeman,
  2. Nicole Yonke
  1. University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
  1. Correspondence to : Dr Lawrence M Leeman, University of New Mexico School of Medicine, MSC 09 5040, Albuquerque, NM 87131, USA; lleeman{at}salud.unm.edu

http://dx.doi.org/10.1136/ebmed-2015-110223

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    Commentary on: Boulvain M, Senat MV, Perrotin F, et al., Groupe de Recherche en Obstétrique et Gynécologie (GROG). Induction of labour versus expectant management for large-for-date fetuses: a randomised controlled trial. Lancet 2015;385:2600–5OpenUrlCrossRefPubMed.

    Context

    Labour induction for large for gestational age (LGA) infants in women without gestational diabetes (GD) has not been recommended due to concern for increasing the likelihood of caesarean delivery and lack of fetal benefit. Some studies comparing labour induction with spontaneous labour have demonstrated higher caesarean rates with induction. However, recent studies using expectant management as the comparison group have not demonstrated an increase of caesarean delivery.1 Studies evaluating term induction for LGA have not shown decreased neonatal morbidity, even though macrosomic fetuses are at increased risk. …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.