title: When should pregnancies that extended beyond term be induced?
abstract: OBJECTIVE
  To compare maternal and neonatal outcomes associated with a policy for induction of labor at ≥ 41 versus at ≥42 weeks'.
  
  
  METHODS
  Retrospective cohort study of a 2 years' period before and after policy change from induction of labor at ≥ 42 gestational weeks' versus ≥41 gestational weeks.
  
  
  RESULTS
  During the 41-policy period (N = 968), the induction rate was higher, 60% versus 40% (p < 0.0001) while the cesarean delivery (CD) rate was lower, 15% versus 19.4% (p = 0.0135). Moreover, among women that were induced, the rate of CD was lower during the 41-policy period, 19% versus 27% (p = 0.0067). No significant differences in maternal or neonatal outcomes were noted. There was one case of intrauterine fetal death at 41 + 4 weeks during the 42-policy period.
  
  
  CONCLUSIONS
  As a policy for induction of labor at ≥ 41 reduces the rate of CD without any adverse maternal or neonatal outcomes, such a policy seems to be superior to a policy for induction at ≥ 42 weeks.
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Inna
authors.initials: I
authors.lastname: Bleicher
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Dana
authors.initials: D
authors.lastname: Vitner
authors.affiliation: b Department of Pediatrics , Bnai-Zion Medical Center, Faculty of Medicine, Technion - Israel Institute of Technology , Haifa , Israel.
authors.forename: Adir
authors.initials: A
authors.lastname: Iofe
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Shlomi
authors.initials: S
authors.lastname: Sagi
authors.affiliation: b Department of Pediatrics , Bnai-Zion Medical Center, Faculty of Medicine, Technion - Israel Institute of Technology , Haifa , Israel.
authors.forename: David
authors.initials: D
authors.lastname: Bader
authors.affiliation: a Department of Obstetrics and Gynecology and.
authors.forename: Ron
authors.initials: R
authors.lastname: Gonen
mesh_terms: D000328:Adult; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced / Q000592:standards*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011273:Pregnancy, Prolonged; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
keywords: Induction of labor; post-date; postterm; prolonged pregnancy