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http://dx.doi.org/10.1007/s11695-021-05881-1DOI Listing

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Background: The risk of perinatal death and severe neonatal morbidity increases gradually after 41 weeks of pregnancy. We evaluated maternal and perinatal outcomes after a national shift from expectancy and induction at 42+0 weeks to a more active management of late-term pregnancies in Sweden offering induction from 41+0 weeks or an individual plan aiming at birth or active labour no later than 42+0 weeks.

Methods And Findings: Women with a singleton pregnancy lasting 41+0 weeks or more with a fetus in cephalic presentation (N = 150,370) were included in a nationwide, register-based cohort study.

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Purpose: There is an ongoing discussion on whether the benefits of term elective labor induction outweigh its potential risks. This study evaluated the utility of a comprehensive clinical examination in identifying low-risk pregnancies suitable for expectant management beyond gestational age 40‒41 weeks and compared their outcomes with earlier labor induction by indication.

Methods: Pregnant women (n = 722) with ≥ 40 + 0 gestational weeks referred to a tertiary hospital were included in this prospective cohort.

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Article Synopsis
  • - This study aimed to find the best time for labor induction in normotensive singleton pregnancies to reduce risks like stillbirth, analyzing 70,293 births in Iceland from 1997 to 2018 while excluding high-risk cases.
  • - Results showed that inducing labor at or after 40 weeks decreased cesarean rates without increasing adverse outcomes, while earlier inductions did not show significant benefits.
  • - The conclusion emphasized that inducing labor post-40 weeks is safer for women without heightening risks for mothers or babies, and earlier induction in low-risk pregnancies isn’t beneficial.
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Background: We aimed to evaluate the trend of post-term births over time and their association with perinatal mortality based on prospective pregnancy cohorts in a rural area in Bangladesh.

Methods: This cohort study included 72 373 singleton births with gestational ages ≥28 weeks recorded by a health and demographic surveillance system from 1990 to 2019 in Matlab, Bangladesh. We expressed the gestational age as X (weeks) + Y (days)/7 weeks, where X indicated complete weeks, and Y presented the number of completed days out of seven days or a week.

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Article Synopsis
  • The Clinical Practice Update incorporates findings from the ARRIVE trial and other studies to enhance guidance for managing pregnancies between 39 to 41 weeks gestation without medical reasons for delivery.
  • This update revises the American College of Obstetricians and Gynecologists' previous recommendations in Practice Bulletin No. 146 from 2014.
  • It replaces earlier clinical guidance related to the ARRIVE trial, which focused on labor versus expectant management for low-risk first-time mothers published in August 2018.
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