الفهرس 
Aim of the studyOnly 14 pages are availabe for public view
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Abstract
Timing of delivery is a vital component of a healthy pregnancy.
Term pregnancy means delivery of fetus between 37 weeks and
41weeks gestational age, preterm delivery means delivery of fetus
before 37weeks gestation while post-term delivery means delivery of
fetus after 41weeks gestation. An increase in morbidity and mortality
exists on both ends of the gestational age. On one hand preterm birth
is the leading cause of neonatal morbidity and mortality in the United
States and is associated with substantial societal and healthcare costs.
On the other, late-term and post-term pregnancies are associated with
increased maternal, fetal and neonatal risks. maternal risks include
cesarean delivery, operative vaginal delivery, and haemorrhage,fetal
macrosomia and shoulder dystocia, cesarean delivery, perineal injury.
While fetal risks include death, low apger score, meconium aspiration,
dysmaturity syndrome. Because of these risks several studies consider
induction of labor between 39 and 41weeks gestational age.
So elective induction of labor at 39 weeks gestational age
avoids potential risks of ongoing pregnancies including pregnancy
induced hypertension and intrauterine fetal death. One European
analysis quantified the total pregnancy loss rate at 39, 40 and 41
weeks as 1.4%, 2.4% and 2.8%, respectively. Additionally, elective
induction decreases the risk of macrosomia with its attendant risk of
shoulder dystocia with or without permanent brachial plexus injury.
Both pregnancy induced hypertension and fetal macrosomia increase
the risk of cesarean delivery.
Additionally, patients with an unfavorable cervix undergoing
induction of labor may carry a higher rate of cesarean delivery. our
objective was to perform a comparative effectiveness analysis of elective induction of labor at 39 weeks gestational age with
uncomplicated pregnancies as compared to expectant management
with induction of labor for standard medical or obstetrical indications
or at 41 weeks gestation in undelivered mothers.