Membrane sweeping to induce labor in low-risk patients at term pregnancy: a randomised controlled trial

Abstract

Objective: To evaluate the efficacy of membrane sweeping at initiation of labor induction in low-risk patients at term pregnancy (38-40 gestational weeks).

Methods: This prospective study included 351 antenatal women who were randomly assigned to one of two groups: a sweeping of the membranes group (n = 181) and a no sweeping control group (n = 170). The primary outcome measure was the proportion of women who entered spontaneous labor within 1 week of entry into the study. Secondary outcome measures included mode of delivery and maternal and fetal complications.

Results: Five patients (two in the sweeping group and three in the no sweeping group) were excluded from the study because of breech presentation at labor. There were no statistically significant differences between the two groups regarding maternal age, parity or Bishop score. The proportion of subjects who entered spontaneous labor before 41 weeks of gestation was significantly different between the two groups (p < 0.0001). The mode of delivery did not differ significantly between the groups and there was no statistically significant difference in maternal or fetal complications.

Conclusions: Sweeping of membranes is a safe method to reduce the length of term in pregnancy and the incidence of prolonged gestation in a low-risk population. There is no evidence that sweeping the membranes increases the risk of maternal or neonatal adverse outcomes.