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SOGC Statement on ARRIVE Trial

The publication of the ARRIVE trial, on elective induction in nulliparous women with a singleton low risk pregnancy at 39 weeks, has elicited a great deal of coverage and commentary. Our clinical committees have reminded us that this, as with any study, needs to be interpreted with care. The induction of labour guideline, which covers both current indications as well as methods, is under revision and this study will be factored into the statements and recommendations arising from that guideline.

A measured interpretation of the results of this study does enable healthcare providers to use their best clinical judgment in the timing of indicated induction in low risk nulliparous women where gestational age is securely known by early ultrasound. However, it is not appropriate to recommend elective induction solely to reduce the risk of caesarean section in an otherwise low risk nulliparous patient at this time.