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Membrane sweeping for induction of labour
1Unité de Développement en Obstétrique, Maternité Hôpitaux Universitaires de Genève, Département de Gynécologie et d'Obstétrique, Boulevard de la Cluse, 32, Geneva 14, Switzerland, CH-1211. michel.boulvain@hcuge.ch
The Cochrane Database of Systematic Reviews
|June 19, 2001
Summary
Membrane sweeping, a method to induce labor, may reduce pregnancy duration but causes discomfort. Its routine use from 38 weeks shows no significant clinical benefits, requiring a balance between reduced formal induction and adverse effects.
Area of Science:
- Obstetrics and Gynecology
- Reproductive Medicine
- Clinical Trials Methodology
Background:
- Membrane sweeping (stripping) is a simple technique to initiate labor by stimulating prostaglandin production.
- It aims to reduce pregnancy duration or avoid formal labor induction methods like oxytocin or prostaglandins.
- This review examines the efficacy and safety of membrane sweeping for third-trimester labor induction.
Purpose of the Study:
- To determine the effects of membrane sweeping for third-trimester labor induction.
- Evaluate the impact on pregnancy duration, need for formal induction, and adverse events.
Main Methods:
- Systematic review of randomized controlled trials (RCTs) identified through the Cochrane Pregnancy and Childbirth Group trials register.
- Searched databases up to November 2000, including relevant paper bibliographies.
- Data extraction and quality assessment followed standardized methodology, comparing membrane sweeping against no treatment, prostaglandins, and oxytocin.
Main Results:
- Nineteen trials were included; 17 compared sweeping to no treatment.
- Membrane sweeping reduced pregnancy duration and the frequency of post-term pregnancies (beyond 41 and 42 weeks).
- Caesarean section rates were similar; however, women experienced more discomfort, bleeding, and irregular contractions.
Conclusions:
- Routine membrane sweeping from 38 weeks offers no significant clinical benefits.
- When used for labor induction, the reduction in formal induction methods must be weighed against maternal discomfort and adverse effects.
- Limited sample sizes in studies comparing sweeping with prostaglandins preclude evidence of benefit.