Clinical Research Directory

Inclusion Criteria: 1. Age ≥18 years. 2. Singleton pregnancy or twin pregnancy reduced to singleton before 14 weeks. 3. Gestational age between 38 weeks 4 days or 39 weeks 3 days at randomization. 4. Eligible for vaginal delivery with a desire for vaginal birth. 5. Reliable gestational age determination. 6. Maternal and fetal conditions assessed as favorable by at least two senior obstetricians, with no indications requiring delivery before 41 weeks. 7. Ability to understand study information and provide informed consent. Exclusion Criteria: 1. First-trimester ultrasound estimate \>13 weeks 6 days. 2. Planned induction before 41 weeks. 3. Planned cesarean delivery or contraindications to vaginal delivery. 4. Already delivered, in labor, or ruptured membranes at enrollment. 5. Placenta previa, vasa previa, placenta accreta, or placental abruption. 6. Contraindications to induction (e.g., cervical cancer, history of uterine rupture, genital tract malformations, abnormal fetal position, cord prolapse). 7. Active vaginal bleeding exceeding spotting. 8. History of cesarean delivery or uterine/cervical surgery. 9. Cervical cerclage during this pregnancy. 10. Maternal conditions not suitable for expectant management beyond 39 weeks (e.g., pregestational diabetes, gestational diabetes requiring insulin, hypertensive disorders, intrahepatic cholestasis of pregnancy). 11. Fetal conditions not suitable for expectant management beyond 39 weeks (e.g., fetal death, major anomalies, growth restriction, macrosomia, anemia, oligohydramnios, polyhydramnios). 12. Maternal infections or positive screenings for sexually transmitted pathogens or group B Streptococcus. 13. Planned delivery at a non-study facility. 14. Participation in another intervention study affecting delivery management.