SMFM Statement on Elective Induction of Labor in Low-Risk Nulliparous Women at Term: the ARRIVE Trial

Am J Obstet Gynecol. 2019 Jul;221(1):B2-B4. doi: 10.1016/j.ajog.2018.08.009. Epub 2018 Aug 9.


A Randomized Trial of Induction Versus Expectant Management (ARRIVE) was conducted by the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network from March 2014 to August 2017.This large multicenter, unmasked, randomized controlled trial was performed to test the hypothesis that elective IOL at 39 weeks of gestation, compared with expectant management among low-risk nulliparous women, reduces the risk of a composite outcome of perinatal death or severe neonatal morbidity. Nulliparous women with reliable dating and no obstetric or medical complications were eligible, regardless of favorability of cervical examination. The purpose of this document is to review the findings of the recent randomized trial and to provide guidance for implementation of the study findings.

Publication types

  • Practice Guideline

MeSH terms

  • Decision Making, Shared*
  • Female
  • Gestational Age*
  • Humans
  • Labor, Induced*
  • Parity*
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Societies, Medical
  • Watchful Waiting*