ACOG: Management of Full-Term Nulliparous Individuals Without a Medical Indication for Delivery – ACOG Clinical Practice Update

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Abstract

This Clinical Practice Update integrates data from a large, randomized controlled trial (the ARRIVE trial [A Randomized Trial of Induction Versus Expectant Management]) and subsequent other related studies into existing American College of Obstetricians and Gynecologists’ guidance regarding management of pregnant individuals at 39 0/7–41 6/7 weeks of gestation without a medical indication for delivery. This document updates Practice Bulletin No. 146, Management of Late-Term and Postterm Pregnancies (Obstet Gynecol 2014;124:390–396) and replaces the Clinical Guidance for Integration of the Findings of the ARRIVE Trial: Labor Versus Expectant Management in Low-Risk Nulliparous Women Practice Advisory, originally published in August 2018.