Wellmann S, Manegold-Brauer G, Fischer T, et al. - A higher respiratory risk has been observed among newborns delivered by elective cesarean section (CS) vs those delivered vaginally or by CS proceeded by labor (secondary CS) and after the oxytocin challenge test (OCT), induction of uterine contractions occurs that triggers the release of fetal hormones regulating lung fluid clearance during transition from the uterine to an air-breathing environment. Researchers aimed to summarize current evidence and outline the Lacarus trial protocol. A randomized placebo-controlled multicenter trial was designed using information from literature review to evaluate OCT preceding elective CS in 1,450 women with a singleton pregnancy due for CS at > 35 weeks gestation, without preceding contractions, rupture of the membranes, or antenatal steroids. The occurrence of neonatal respiratory morbidity within 24 h after birth was assessed as the primary endpoint. Biochemical and physiological parameters of fetal and maternal well-being, such as breastfeeding rate and fetal plasma copeptin concentrations were assessed as secondary endpoints. In this trial, for the first time, the hypothesis was tested that oxytocin-induced contractions prior to elective CS is a promising application of physiologic principles gleaned from natural birth to improve neonatal and maternal outcomes.