A Randomized Trial of Induction Versus Expectant Management

Exclusion Criteria

• •3. Gestational age at randomization between 38 weeks 0 days and 38 weeks 6 days inclusive based on clinical information and evaluation of the earliest ultrasound.
• •1. Project gestational age at date of first ultrasound is \> 20 weeks 6 days
• •2. Plan for induction of labor prior to 40 weeks 5 days
• •3. Plan for cesarean delivery or contraindication to labor
• •4. Breech presentation
• •5. Signs of labor (regular painful contractions with cervical change)
• •6. Fetal demise or known major fetal anomaly
• •7. Heparin or low-molecular weight heparin during the current pregnancy
• •8. Placenta previa, accreta, vasa previa
• •9. Active vaginal bleeding greater than bloody show
• •10. Ruptured membranes
• •11. Cerclage in current pregnancy
• •12. Known oligohydramnios, defined as AFI \< 5 or MVP \< 2
• •13. Fetal growth restriction, defined as EFW \< 10th percentile
• •14. Known HIV positivity because of modified delivery plan
• •15. Major maternal medical illness associated with increased risk for adverse pregnancy outcome (for example, any diabetes mellitus, lupus, any hypertensive disorder, cardiac disease, renal insufficiency)
• •16. Refusal of blood products
• •17. Participation in another interventional study that influences management of labor at delivery or perinatal morbidity or mortality
• •18. Delivery planned elsewhere at a non-Network site