Membrane sweeping for induction of labour.

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Evidence-Based Medicine

Background:

• Induction of labour utilizes artificial methods to initiate uterine contractions.
• Membrane sweeping is a mechanical technique involving cervical stimulation to promote labour onset.
• This review updates previous findings on membrane sweeping published in 2005.

Purpose of the Study:

• To evaluate the efficacy and safety of membrane sweeping for labour induction in women at or beyond 36 weeks of gestation.
• To synthesize current evidence on membrane sweeping compared to placebo or other induction methods.

Main Methods:

• Systematic review and meta-analysis of randomized and quasi-randomized controlled trials.
• Searched major clinical trial registries and databases up to February 2019.
• Assessed risk of bias and certainty of evidence using the GRADE approach.

Main Results:

• Membrane sweeping may increase the spontaneous onset of labour (low-certainty evidence) and reduce the need for formal induction.
• No significant differences observed in rates of caesarean section, spontaneous vaginal birth, or maternal/neonatal mortality compared to expectant management.
• Limited data comparing membrane sweeping with prostaglandins, oxytocin, or misoprostol showed no clear differences in key outcomes.
• Women generally reported positive experiences and perceived cost-effectiveness compared to prostaglandins.

Conclusions:

• Membrane sweeping shows potential for spontaneous labour onset, but evidence certainty is low.
• It may reduce the incidence of formal induction of labour compared to expectant management.
• Further research is needed to determine optimal protocols for membrane sweeping, including frequency and timing.