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Induction group acceptance created the intervention arm, while decliners discharged home formed controls. Induction lowered gestational age at delivery and improved umbilical cord pH without increasing cesarean delivery, maternal complications, or neonatal NICU admission.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/immediate-induction-versus-expectant-management-in-primiparas-presenting-with-decreased-fetal-movements-at-39-weeks/453373/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/immediate-induction-versus-expectant-management-in-primiparas-presenting-with-decreased-fetal-movements-at-39-weeks/453373.png","ImageObject",300,407,{"name":42,"@type":43},"Liam","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-03","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What clinical scenario does the study evaluate?","Question",{"text":63,"@type":64},"Primiparous patients presenting with decreased fetal movements at 39+0 to 39+6 weeks, with a reassuring fetal assessment and normal biophysical profile.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How did the researchers compare induction versus expectant management?",{"text":68,"@type":64},"Patients offered labor induction were grouped by choice: those who agreed formed the induction group, while those who declined and were discharged home comprised the expectant management control group.",{"name":70,"@type":61,"acceptedAnswer":71},"What were the main outcome findings?",{"text":72,"@type":64},"Immediate induction led to earlier delivery and improved umbilical cord pH, with no significant differences in birthweight, cesarean rates, or NICU admissions. 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Patients were offered labor induction. Those who agreed formed the induction group, while those who declined and were discharged home comprised the control group. Maternal and neonatal outcomes were compared.  \nResults A total of 413 patients were included: 282 in the induction group and 131 in the expectant management group. Gestational age at delivery was lower in the induction group (39.4 ± 0.3 vs. 40.1 ± 0.3 weeks, p \u003C 0.001) . No significant differences were observed in birthweight, cesarean delivery rates, or neonatal intensive care unit (NICU) admission. The induction group had significantly fewer neonates with cord pH \u003C 7.15 (2.5% vs. 6.9%, p = 0.034), and a shorter duration of neonatal hospitalization (2.0 ± 0.2 vs. 2.3 ± 0.5 days, p = 0.034); however, 5-min Apgar scores were similar between the groups. Total maternal hospitalization duration was significantly longer in the induction group (3.6 ± 0.6 vs. 2.2 ± 0.5 days, p \u003C 0.001), though postpartum stay was slightly shorter (2.0 ± 0.2 vs. 2.2 ± 0.1 days, p \u003C 0.001) .  \nConclusion Among primiparous patients presenting with DFM between 39 + 0 and 39 + 6 weeks, labor induction was associated with earlier delivery and improved umbilical cord pH without increasing maternal or neonatal complications.  \nKeywords Decreased fetal movements · Induction of labor · Expectant management · Primiparous patients · Maternal outcomes · Neonatal outcomes  \nRaneen Abu Shqara and Kylie Ella Marcovich have contributed equally to this work.  \n* Raneen Abu Shqara [rabushqara@gmail.com](rabushqara@gmail.com)  \n1 Raya Strauss Wing of Obstetrics and Gynecology, Galilee Medical Center, Nahariya, Israel  \n2 Azrieli Faculty of Medicine, Bar Ilan University, Safed, Israel  \nWhat this study adds to clinical practice  \nThis study provides new evidence to guide the management of primiparous patients presenting at 39 weeks with decreased fetal movements (DFM) anda reassuring fetal assessment. Immediate induction of labor was associated with earlier delivery and improved umbilical cord pH values, without increasing rates of cesarean delivery, maternal complications, or neonatal morbidity. These findings support offering induction as a safe option in this clinical scenario while recognizing that expectant management with close surveillance also remains appropriate. This evidence may assist clinicians in counseling patients and individualizing care plans when DFM occurs at term.  \nIntroduction  \nDecreased fetal movements (DFM) in late pregnancy are linked to higher risks of adverse outcomes, including stillbirth, neonatal morbidity, and maternal anxiety [1–3] . The diagnosis of DFM remains challenging owing to the absence of universally accepted diagnostic criteria. Among the various assessment strategies, the 'count-to-ten' fetal movement counting method—whereby the pregnant individual records the time taken to perceive ten discrete movements—is the most widely adopted approach in clinical practice and is endorsed by many obstetric care p","cbCaihVGF6PnEcX5","https://ap.wps.com/l/cbCaihVGF6PnEcX5","pdf",624172,"English","# Abstract\n## Objective\n## Study design\n## Results\n## Conclusion\n## Keywords\n# Introduction\n## Background and diagnostic context\n## Prevalence and associated risks\n## Management debate and existing initiatives","[{\"question\":\"What clinical scenario does the study evaluate?\",\"answer\":\"Primiparous patients presenting with decreased fetal movements at 39+0 to 39+6 weeks, with a reassuring fetal assessment and normal biophysical profile.\"},{\"question\":\"How did the researchers compare induction versus expectant management?\",\"answer\":\"Patients offered labor induction were grouped by choice: those who agreed formed the induction group, while those who declined and were discharged home comprised the expectant management control group.\"},{\"question\":\"What were the main outcome findings?\",\"answer\":\"Immediate induction led to earlier delivery and improved umbilical cord pH, with no significant differences in birthweight, cesarean rates, or NICU admissions. Neonatal hospitalization duration was shorter, while 5-minute Apgar scores were similar.\"}]","Immediate induction versus expectant management in primiparas presenting with decreased fetal movements at 39 weeks | PDF",1790738765,18]