Membrane sweeping for induction of labour

Abstract

Analysis 2.31. Comparison 2 (1.2)Membranes sweeping versus no treatment: all women, unfavourable cervix, Outcome 31 Not delivered before 42 weeks (not prespecified

Obstetric care in low-resource settings: What, who, and how to overcome challenges to scale up?

“…Membrane sweeping disrupts decidual cell lysosomes and releases prostaglandins, in some cases stimulating cervical ripening and/or the initiation of labor. A Cochrane review found that membrane sweeping was significantly associated with reduced risk of pregnancy continuation beyond 41 weeks (RR 0.59; 95% CI, 0.46-0.74) and 42 weeks (RR 0.28; 95% CI, 0.15-0.50) [113], but no difference in perinatal outcome was observed. However, all pregnancies in the trial settings were closely monitored, and both intervention and control groups were offered routine labor induction at 41 or 42 weeks.…”

Can Term Gestation Be Induced by Misoprostol on Opd Basis?

“…No harmful adverse effects of Membrane Stripping have been reported in previous studies. 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.…”

“…Various medical surgical and combined methods of cervical ripening and induction are in practice. Stripping of membranes from the lower segment of the uterus is the commonly used method of induction which does not require admission in hospital 9,10 . The results of effectiveness of stripping do not agree with each other 2,7,10 .…”

How to avoid iatrogenic morbidity and mortality while increasing availability of oxytocin and misoprostol for PPH prevention?

“…Because of concern regarding use of uterotonics in peripheral health centers without access to cesarean delivery, and the fact that they are simple to use, low risk, and low cost, we included Cochrane reviews addressing nonpharmacological methods of labor induction such as mechanical dilation of the cervix with Foley catheter or laminaria, extra-amniotic infusion, sweeping of the membranes, and artificial rupture of membranes [55][56][57]. Furthermore, these nonpharmacological methods are suggested in international obstetric practice guidelines as potential means of avoiding induction for a post-dates pregnancy.…”