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Membrane Sweeping in Conjunction With Labor Induction

From the Department of Obstetrics & Gynaecology, National University Hospital, Singapore.

Address reprint requests to: L. C. Foong, MD National University Hospital, Singapore Department of Obstetrics and Gynaecology 5 Lower Kent Ridge Road 119074 Singapore E-mail: obgflc{at}leonis.nus.edu.sg

Objective: To determine whether cervical membrane sweeping (stripping) during induction of labor is beneficial.

Methods: We compared outcomes of labor after induction in pregnant women at term in a randomized trial. Women were assigned to having their membranes swept or not during induction. Outcome measures included duration of labor, maximum dose of oxytocin used, induction-labor interval, and mode of delivery.

Results: We recruited 130 nulliparas (64 sweep, 66 non-sweep) and 118 multiparas (60 sweep, 58 nonsweep). Among nulliparas who received intravaginal prostaglandin (PG) E₂ and oxytocin, those who had simultaneous sweeping had significantly shorter mean (± standard error of mean) induction-labor interval (13.6 ± 1.4 versus 17.3 ± 1.2 hours, P = .048), lower mean maximum dose of oxytocin (6.8 ± 0.8 versus 10.35 ± 1.1 mU/minute, P = .01), and increased normal delivery rates (vaginal delivery 83.3% versus 58.2%, P = .01). Sweeping also had a favorable effect on nulliparas who received oxytocin alone (mean induction-labor interval 5.8 ± 3.1 versus 11.2 ± 3.6 hours, P = .04; mean maximum dose 8.8 ± 1.3 versus 16.3 ± 1.9 mU/min, P = .01). Those differences were limited to women with unfavorable cervices. There were no differences in any outcome measures in multiparous women.

Conclusion: Sweeping of the membranes during induction of labor had a beneficial effect on labor and delivery, which appeared to be limited to nulliparas with unfavorable cervices who needed cervical priming with PGE₂.

This article has been cited by other articles:

				P. C. Tan, R. Jacob, and S. Z. Omar Membrane sweeping at initiation of formal labor induction: a randomized controlled trial. Obstet. Gynecol., March 1, 2006; 107(3): 569 - 577. [Abstract] [Full Text] [PDF]