We studied 1542 women with uncomplicated pregnancies of 41 or more weeks' gestation. The women were randomly assigned to undergo induction of labor or to have serial antenatal monitoring and spontaneous labor unless there was evidence of fetal or
maternal compromise, in which case labor was induced or cesarean section was performed. In the induction group, labor was induced by the intravaginal application of prostaglandin E2. Serial antenatal monitoring consisted of nonstess test,
assessments of
amniotic fluid volume, and biophysical profile.
Among 702 women in the induction group 111(15.8%) resulted in a higher rate of cesarean section., as compared with 82(9.8%) of 840 women in the monitoring group. This difference resulted from a higher rate of cesarean section performed because
failure
to progress in the induction group(9.4%) versus 2.7%, P<0.005). But the rate of cesarean section because of fetal distress in the induction group was significantly lower than the monitoring group (6.1% versus 9.7%, P<0.05). the rate of perinatal
morality in the induction group was significantly lower than the monitoring group(1.4 per 1000 versus 7.1 per 1000, 0<0.005).
therefore, in postterm pregnancy, the induction of labor resulted in a higher rate of cesarean section for failure to progress, but a lower rate of cesarean section for fetal distress, the lower rates of perinatal mortality and neonatal morbidity
compared with serial antenatal monitoring.
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