Membrane sweeping vs double-balloon catheter for cervical ripening: a randomized controlled trial

Area of Science:

• Obstetrics and Gynecology
• Reproductive Medicine
• Clinical Trials

Background:

• Membrane sweeping is a cost-effective method to promote spontaneous labor at term.
• It is as effective as prostaglandins or oxytocin for vaginal delivery.
• The double-balloon catheter is a common method for cervical ripening, but direct comparisons are lacking.

Purpose of the Study:

• To compare the effectiveness of membrane sweeping versus double-balloon catheter for cervical ripening in term pregnancies.
• To evaluate outcomes including Bishop score changes, time to delivery, and oxytocin use.

Main Methods:

• A randomized controlled trial compared membrane sweeping (twice) with a double-balloon catheter (12 hours).
• The primary outcome was the change in Bishop score at 12 hours.
• Secondary outcomes included time to ripening/delivery, oxytocin use, pain (VAS), and patient satisfaction.

Main Results:

• Membrane sweeping was non-inferior to the double-balloon catheter in improving Bishop scores (Δ Bishop score: 2 vs. 2, p=0.657).
• Membrane sweeping was associated with significantly lower oxytocin use (63.8% vs. 94.3%, p<0.001) and shorter delivery room stay (8.9h vs. 12.8h, p=0.002).
• Delivery within 16 hours was more frequent with membrane sweeping (35.1% vs. 16.0%, p=0.025).

Conclusions:

• Membrane sweeping is non-inferior to the double-balloon catheter for cervical ripening.
• It offers advantages of reduced oxytocin requirement and faster delivery.
• Membrane sweeping is a potentially preferable, low-cost, minimally invasive option for selected term pregnancies.