Does sweeping of the membranes reduce the need for formal induction of labour? A randomized controlled trial

Boulvain, Michel; Fraser, William D.; Marcoux, Sylvie; Fontaine, Jean-Yves; Bazin, Sylvie; Pinault, Jean-Jacques; Blouin, Daniel

doi:10.1111/j.1471-0528.1998.tb09347.x

Cited by 42 publications

(29 citation statements)

References 15 publications

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“…10 Reported adverse effects of misoprostol, such as vomiting, diarrhoea, tachysystole or hyperstimulation, were not recorded in this study, possibly because of the single low dose administered. However, 20% of all the patients (in Stripping group and stripping along with Misoprostol group) reported that the procedure was uncomfortable and/or painful, similar to earlier reports, 15,20 and 6% had minimal spotting after the procedure, which subsequently subsided. No case of rupture of the membranes or antepartum haemorrhage was recorded.…”

Section: Resultssupporting

confidence: 66%

Can Term Gestation Be Induced by Misoprostol on Opd Basis?

Javadekar¹,

Rokade²

2013

jemds

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Stripping of membranes is wide used as OPD procedure for preripening and induction of labour. This study was planned to assess whether or not low single dose of vaginal misoprostol ( 25 mcg.) can be added to stripping in OPD and what is going to be the impact on the end result of labour induction. The study was applied in Datta Sugar mill Charitable Hospital, Shirol, Dist. Kolhapur. A total of eighty patients were taken for the study. They were divided in 2 equal teamsGroup A with solely stripping of membranes and Group B Stripping along with 25 mcg Misoprostol. Primary observations were delivery at intervals forty eight hours from the beginning of induction and route of delivery. Secondary observations were interval from induction to onset of labour (latency period), interval from begin of induction to delivery (duration of labour), want for oxytocin augmentation, labour complications, Apgar scores at one and five minutes. Both teams were similar at begin with respect to age, parity and between forty weeks and forty one weeks gestation. There was a considerably shorter induction to onset of labour interval within the B group. The period of labour was considerably shorter in B group. Overall, baby outcomes were similar and comparable within the 2 teams. The study gave following results and conclusionThe patients who received Stripping with vaginal 25mcg.Misoprostol showed 1. A shorter latency period, 2. Less need for oxytocin augmentation, 3. Shorter duration of labour in patients. The two induction strategies were similar with respect to baby outcomes. each were found safe as OPD strategies, though any assessment of the security profile with larger studies are required. More patients felt positive about the intervention in B group than in A group.

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Section: Resultssupporting

confidence: 66%

Can Term Gestation Be Induced by Misoprostol on Opd Basis?

Javadekar¹,

Rokade²

2013

jemds

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“…In addition, to avoid interference with obstetric indications for induction of labour before 42 weeks, we evaluated sweeping in a low-risk population in a primary care setting. A major difference with most trials, in which sweeping was performed by one or two obstetricians, was the participation of many different midwives, 30 implying that our results reflect real practice. We also followed the suggestion of a strategy of multiple successive sweeping 10,18 rather than a single intervention.…”

Section: Discussionmentioning

confidence: 97%

Membrane sweeping and prevention of post‐term pregnancy in low‐risk pregnancies: a randomised controlled trial

Miranda

Bom

Bonsel³

et al. 2006

BJOG

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Objective To evaluate the effectiveness of membrane sweeping at 41 weeks for the prevention of post-term pregnancy.Design A multicentre randomised controlled trial.Setting Fifty-one primary care midwifery practices in the Netherlands.Population A total of 742 low-risk pregnant women at 41 weeks of gestation.Methods Participants were randomly assigned to serial sweeping of the membranes (every 48 hours until labour commenced up to 42 weeks of gestation) or no intervention.Main outcome measures Post-term pregnancy ( ‡42 weeks). Subgroup analyses were performed on nulliparous and parous women. Secondary outcomes included adverse effects. NNT 6 [95% CI 4-6]). Adverse effects were similar in both the groups except for uncomplicated bleeding, which was reported more frequently in the sweeping group. Other obstetric outcomes and indicators of neonatal morbidity were similar in both groups. There were two perinatal deaths in each group.Conclusions Membrane sweeping at 41 weeks can substantially reduce the proportion of women with post-term pregnancy.

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“…Recently, several studies reported the effectiveness of sweeping of the fetal membranes in reducing the incidence of prolonged pregnancies and the length of term gestations [5,6,12,13]. On the contrary, other authors reported that sweeping of the fetal membranes does not significantly increase the proportion of women who begin spontaneous labor [4,7,13,14].…”

Section: Discussionmentioning

confidence: 89%

Sweeping of the Membranes versus Uterine Stimulation by Oxytocin in Nulliparous Women

Salamalekis¹,

Vitoratos²,

Kassanos³

et al. 2000

Gynecol Obstet Invest

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The aim of this study was to evaluate whether sweeping of the membranes at term could shorten the length of pregnancy and reduce the incidence of postterm pregnancies. We randomly selected 104 nulliparas with uncomplicated pregnancy and gestational age between 281 and 287 days. Our patients were divided into three groups. Group A consisted of 34 women who were subjected to sweeping of the membranes. Uterine stimulation with oxytocin was applied in 35 women (group B), and 35 women (group C) were used as a control group. We had no significant reduction of the time interval from sweeping of the membranes until delivery (1.9 ± 1.2 days), compared to that of group B (2.1 ± 0.8 days) as well as that of the control group (2.5 ± 0.9 days). The incidence of spontaneous labor in patients after sweeping of the membranes was greater (67.6%) when compared with oxytocin-stimulated patients and the control group (p < 0.05). Furthermore, a better Bishop score was noted in patients of group A. No statistically significant difference was noted in the mode of delivery between the groups, but sweeping of the membranes significantly decreased the incidence of postterm pregnancies (p < 0.05). We concluded that sweeping of the membranes is an effective method for initiating labor in women with a gestational age between 40 and 41 weeks, thus reducing the need for induction.

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Does sweeping of the membranes reduce the need for formal induction of labour? A randomized controlled trial

Cited by 42 publications

References 15 publications

Can Term Gestation Be Induced by Misoprostol on Opd Basis?

Can Term Gestation Be Induced by Misoprostol on Opd Basis?

Membrane sweeping and prevention of post‐term pregnancy in low‐risk pregnancies: a randomised controlled trial

Sweeping of the Membranes versus Uterine Stimulation by Oxytocin in Nulliparous Women

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