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Does sweeping of the membranes reduce the need for formal induction of labour? A randomised controlled trial
M Boulvain1, W D Fraser, S Marcoux
1Centre Hospitalier Universitaire de Québec, Pavillon Saint-François d'Assise, Québec.
Objective:
1. To evaluate the effectiveness of sweeping of the membranes to reduce the need for a formal induction of labour; 2. to evaluate the side effects of this intervention.
Design:
A randomised controlled clinical trial.
Setting:
Three tertiary care hospitals of the province of Quebec, Canada.
Population:
Two hundred women for whom non-urgent induction of labour was medically indicated.
Methods:
Women were randomly allocated to sweeping of membranes, or vaginal examination for Bishop scoring only.
Main Outcome Measures:
1. Cumulative incidence and relative risk of induction of labour by either oxytocin, prostaglandins or amniotomy; 2. women's discomfort and side effects attributable to sweeping of the membranes.
Results:
Women allocated to sweeping of the membranes required formal induction of labour less frequently than women in the control group, but this difference was not statistically significant (49% vs 60%, RR 0.83, 95% CI 0.64-1.07). Pain during vaginal examination and other side effects were more frequently reported by women allocated to the sweeping group.
Conclusions:
The observed reduction in the need for formal induction of labour is smaller than in previous studies. Side effects and discomfort associated with sweeping of the membranes must be taken into account when counselling women who require induction of labour.