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Meta-Analysis
. 2020 Feb 27;2(2):CD000451.
doi: 10.1002/14651858.CD000451.pub3.

Membrane sweeping for induction of labour

Elaine M Finucane  1 , Deirdre J Murphy  2 , Linda M Biesty  3 , Gillian Ml Gyte  4 , Amanda M Cotter  5 , Ethel M Ryan  6 , Michel Boulvain  7 , Declan Devane  3
Affiliations
Meta-Analysis

Membrane sweeping for induction of labour

Elaine M Finucane et al. Cochrane Database Syst Rev. .

Abstract

Background: Induction of labour involves stimulating uterine contractions artificially to promote the onset of labour. There are several pharmacological, surgical and mechanical methods used to induce labour. Membrane sweeping is a mechanical technique whereby a clinician inserts one or two fingers into the cervix and using a continuous circular sweeping motion detaches the inferior pole of the membranes from the lower uterine segment. This produces hormones that encourage effacement and dilatation potentially promoting labour. This review is an update to a review first published in 2005.

Objectives: To assess the effects and safety of membrane sweeping for induction of labour in women at or near term (≥ 36 weeks' gestation).

Search methods: We searched Cochrane Pregnancy and Childbirth's Trials Register (25 February 2019), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (25 February 2019), and reference lists of retrieved studies.

Selection criteria: Randomised and quasi-randomised controlled trials comparing membrane sweeping used for third trimester cervical ripening or labour induction with placebo/no treatment or other methods listed on a predefined list of labour induction methods. Cluster-randomised trials were eligible, but none were identified.

Data collection and analysis: Two review authors independently assessed studies for inclusion, risk of bias and extracted data. Data were checked for accuracy. Disagreements were resolved by discussion, or by including a third review author. The certainty of the evidence was assessed using the GRADE approach.

Main results: We included 44 studies (20 new to this update), reporting data for 6940 women and their infants. We used random-effects throughout. Overall, the risk of bias was assessed as low or unclear risk in most domains across studies. Evidence certainty, assessed using GRADE, was found to be generally low, mainly due to study design, inconsistency and imprecision. Six studies (n = 1284) compared membrane sweeping with more than one intervention and were thus included in more than one comparison. No trials reported on the outcomes uterine hyperstimulation with/without fetal heart rate (FHR) change, uterine rupture or neonatal encephalopathy. Forty studies (6548 participants) compared membrane sweeping with no treatment/sham Women randomised to membrane sweeping may be more likely to experience: · spontaneous onset of labour (average risk ratio (aRR) 1.21, 95% confidence interval (CI) 1.08 to 1.34, 17 studies, 3170 participants, low-certainty evidence). but less likely to experience: · induction (aRR 0.73, 95% CI 0.56 to 0.94, 16 studies, 3224 participants, low-certainty evidence); There may be little to no difference between groups for: · caesareans (aRR 0.94, 95% CI 0.85 to 1.04, 32 studies, 5499 participants, moderate-certainty evidence); · spontaneous vaginal birth (aRR 1.03, 95% CI 0.99 to 1.07, 26 studies, 4538 participants, moderate-certainty evidence); · maternal death or serious morbidity (aRR 0.83, 95% CI 0.57 to 1.20, 17 studies, 2749 participants, low-certainty evidence); · neonatal perinatal death or serious morbidity (aRR 0.83, 95% CI 0.59 to 1.17, 18 studies, 3696 participants, low-certainty evidence). Four studies reported data for 480 women comparing membrane sweeping with vaginal/intracervical prostaglandins There may be little to no difference between groups for the outcomes: · spontaneous onset of labour (aRR, 1.24, 95% CI 0.98 to 1.57, 3 studies, 339 participants, low-certainty evidence); · induction (aRR 0.90, 95% CI 0.56 to 1.45, 2 studies, 157 participants, low-certainty evidence); · caesarean (aRR 0.69, 95% CI 0.44 to 1.09, 3 studies, 339 participants, low-certainty evidence); · spontaneous vaginal birth (aRR 1.12, 95% CI 0.95 to 1.32, 2 studies, 252 participants, low-certainty evidence); · maternal death or serious morbidity (aRR 0.93, 95% CI 0.27 to 3.21, 1 study, 87 participants, low-certainty evidence); · neonatal perinatal death or serious morbidity (aRR 0.40, 95% CI 0.12 to 1.33, 2 studies, 269 participants, low-certainty evidence). One study, reported data for 104 women, comparing membrane sweeping with intravenous oxytocin +/- amniotomy There may be little to no difference between groups for: · spontaneous onset of labour (aRR 1.32, 95% CI 88 to 1.96, 1 study, 69 participants, low-certainty evidence); · induction (aRR 0.51, 95% CI 0.05 to 5.42, 1 study, 69 participants, low-certainty evidence); · caesarean (aRR 0.69, 95% CI 0.12 to 3.85, 1 study, 69 participants, low-certainty evidence); · maternal death or serious morbidity was reported on, but there were no events. Two studies providing data for 160 women compared membrane sweeping with vaginal/oral misoprostol There may be little to no difference between groups for: · caesareans (RR 0.82, 95% CI 0.31 to 2.17, 1 study, 96 participants, low-certainty evidence). One study providing data for 355 women which compared once weekly membrane sweep with twice-weekly membrane sweep and a sham procedure There may be little to no difference between groups for: · induction (RR 1.19, 95% CI 0.76 to 1.85, 1 study, 234 participants, low-certainty); · caesareans (RR 0.93, 95% CI 0.60 to 1.46, 1 study, 234 participants, low-certainty evidence); · spontaneous vaginal birth (RR 1.00, 95% CI 0.86 to 1.17, 1 study, 234 participants, moderate-certainty evidence); · maternal death or serious maternal morbidity (RR 0.78, 95% CI 0.30 to 2.02, 1 study, 234 participants, low-certainty evidence); · neonatal death or serious neonatal perinatal morbidity (RR 2.00, 95% CI 0.18 to 21.76, 1 study, 234 participants, low-certainty evidence); We found no studies that compared membrane sweeping with amniotomy only or mechanical methods. Three studies, providing data for 675 women, reported that women indicated favourably on their experience of membrane sweeping with one study reporting that 88% (n = 312) of women questioned in the postnatal period would choose membrane sweeping in the next pregnancy. Two studies reporting data for 290 women reported that membrane sweeping is more cost-effective than using prostaglandins, although more research should be undertaken in this area.

Authors' conclusions: Membrane sweeping may be effective in achieving a spontaneous onset of labour, but the evidence for this was of low certainty. When compared to expectant management, it potentially reduces the incidence of formal induction of labour. Questions remain as to whether there is an optimal number of membrane sweeps and timings and gestation of these to facilitate induction of labour.

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Conflict of interest statement

Elaine M Finucane: this review was supported by Health Research Board, Ireland (HRB) through a HRB Cochrane Fellowship. We acknowledge gratefully the support of the University Of Limerick Hospitals Group and the Nursing and Midwifery Planning and Development Unit West/Midwest of the Health Service Executive, Ireland (HSE).

Deirdre J Murphy: none known.

Linda M Biesty: none known.

Gillian ML Gyte: I have received royalties from John Wiley & Sons in respect of 'A Cochrane Pocketbook ‐ Pregnancy and Childbirth' Hofmeyr GJ et al. 2008.

Amanda M Cotter: none known.

Ethel M Ryan: none known.

Michel Boulvain: Michel is a principal investigator in one of the included studies (Boulvain 1998) and was the principle author of the original 2005 Cochrane Review ‘Membrane sweeping for induction of labour’ (Boulvain 2005). He was not involved in the data collection for this update, nor in the assessment of bias.

Declan Devane: Declan is PI for a grant from the HRB to assess the feasibility of conducting a definitive randomised trial to examine the effectiveness of membrane sweeping to prevent drug‐ based induction of labour in women at or near term, to explore women and clinicians acceptability of and willingness to participate in the trial and to evaluate the effects of social media study promotion on recruitment.

Figures

1
1
Study flow diagram.
2
2
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 1 Spontaneous onset of labour.
1.2
1.2. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 2 Induction of labour.
1.3
1.3. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 3 Caesarean section.
1.4
1.4. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 4 Spontaneous vaginal birth.
1.5
1.5. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 5 Maternal death or serious morbidity.
1.6
1.6. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 6 Neonatal death or serious neonatal perinatal morbidity.
1.7
1.7. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 7 Instrumental vaginal birth.
1.8
1.8. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 8 Epidural analgesia.
1.9
1.9. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 9 Postpartum haemorrhage.
1.10
1.10. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 10 Augmentation of labour.
1.11
1.11. Analysis
Comparison 1 Amniotic membranes sweeping versus no treatment/sham, Outcome 11 Apgar score less than seven at five minutes.
2.1
2.1. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 1 Spontaneous onset of labour.
2.2
2.2. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 2 Induction of labour.
2.3
2.3. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 3 Caesarean section.
2.4
2.4. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 4 Spontaneous vaginal birth.
2.5
2.5. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 5 Maternal death or serious morbidity.
2.6
2.6. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 6 Neonatal death or serious neonatal perinatal morbidity.
2.7
2.7. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 7 Instrumental vaginal birth.
2.8
2.8. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 8 Augmentation of labour.
2.9
2.9. Analysis
Comparison 2 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins, Outcome 9 Apgar score less than seven at five minutes.
3.1
3.1. Analysis
Comparison 3 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy, Outcome 1 Spontaneous onset of labour.
3.2
3.2. Analysis
Comparison 3 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy, Outcome 2 Induction of labour.
3.3
3.3. Analysis
Comparison 3 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy, Outcome 3 Caesarean section.
3.4
3.4. Analysis
Comparison 3 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy, Outcome 4 Maternal death or serious morbidity.
5.1
5.1. Analysis
Comparison 5 Amniotic membranes sweeping versus vaginal/oral misoprostol, Outcome 1 Caesarean section.
5.2
5.2. Analysis
Comparison 5 Amniotic membranes sweeping versus vaginal/oral misoprostol, Outcome 2 Augmentation of labour.
5.3
5.3. Analysis
Comparison 5 Amniotic membranes sweeping versus vaginal/oral misoprostol, Outcome 3 Apgar score less than seven at five minutes.
7.1
7.1. Analysis
Comparison 7 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping, Outcome 1 Induction of labour.
7.2
7.2. Analysis
Comparison 7 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping, Outcome 2 Caesarean section.
7.3
7.3. Analysis
Comparison 7 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping, Outcome 3 Spontaneous vaginal birth.
7.4
7.4. Analysis
Comparison 7 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping, Outcome 4 Maternal death or serious morbidity.
7.5
7.5. Analysis
Comparison 7 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping, Outcome 5 Neonatal death or serious neonatal perinatal morbidity.
7.6
7.6. Analysis
Comparison 7 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping, Outcome 6 Instrumental vaginal birth.
7.7
7.7. Analysis
Comparison 7 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping, Outcome 7 Apgar score less than seven at five minutes.
8.1
8.1. Analysis
Comparison 8 Amniotic membranes sweeping versus no treatment/sham (Primiparae/Multiparae), Outcome 1 Spontaneous onset of labour.
8.2
8.2. Analysis
Comparison 8 Amniotic membranes sweeping versus no treatment/sham (Primiparae/Multiparae), Outcome 2 Induction of labour.
8.3
8.3. Analysis
Comparison 8 Amniotic membranes sweeping versus no treatment/sham (Primiparae/Multiparae), Outcome 3 Caesarean section.
8.4
8.4. Analysis
Comparison 8 Amniotic membranes sweeping versus no treatment/sham (Primiparae/Multiparae), Outcome 4 Spontaneous vaginal birth.
8.5
8.5. Analysis
Comparison 8 Amniotic membranes sweeping versus no treatment/sham (Primiparae/Multiparae), Outcome 5 Maternal death or serious morbidity.
8.6
8.6. Analysis
Comparison 8 Amniotic membranes sweeping versus no treatment/sham (Primiparae/Multiparae), Outcome 6 Neonatal death or serious neonatal perinatal morbidity.
10.1
10.1. Analysis
Comparison 10 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Primiparae/Multiparae), Outcome 1 Spontaneous onset of labour.
10.2
10.2. Analysis
Comparison 10 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Primiparae/Multiparae), Outcome 2 Induction of labour.
10.3
10.3. Analysis
Comparison 10 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Primiparae/Multiparae), Outcome 3 Caesarean section.
10.4
10.4. Analysis
Comparison 10 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Primiparae/Multiparae), Outcome 4 Maternal death or serious morbidity.
13.1
13.1. Analysis
Comparison 13 Amniotic membranes sweeping versus no treatment/sham Favourable cervix/unfavourable cervix, Outcome 1 Spontaneous onset of labour.
13.2
13.2. Analysis
Comparison 13 Amniotic membranes sweeping versus no treatment/sham Favourable cervix/unfavourable cervix, Outcome 2 Induction of labour.
13.3
13.3. Analysis
Comparison 13 Amniotic membranes sweeping versus no treatment/sham Favourable cervix/unfavourable cervix, Outcome 3 Caesarean section.
13.4
13.4. Analysis
Comparison 13 Amniotic membranes sweeping versus no treatment/sham Favourable cervix/unfavourable cervix, Outcome 4 Spontaneous vaginal birth.
13.5
13.5. Analysis
Comparison 13 Amniotic membranes sweeping versus no treatment/sham Favourable cervix/unfavourable cervix, Outcome 5 Maternal death or serious morbidity.
13.6
13.6. Analysis
Comparison 13 Amniotic membranes sweeping versus no treatment/sham Favourable cervix/unfavourable cervix, Outcome 6 Neonatal death or serious neonatal perinatal morbidity.
14.1
14.1. Analysis
Comparison 14 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins (Favourable cervix/unfavourable cervix), Outcome 1 Spontaneous onset of labour.
14.2
14.2. Analysis
Comparison 14 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins (Favourable cervix/unfavourable cervix), Outcome 2 Induction of labour.
14.3
14.3. Analysis
Comparison 14 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins (Favourable cervix/unfavourable cervix), Outcome 3 Caesarean section.
14.4
14.4. Analysis
Comparison 14 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins (Favourable cervix/unfavourable cervix), Outcome 4 Spontaneous vaginal birth.
14.5
14.5. Analysis
Comparison 14 Amniotic membranes sweeping versus vaginal/intracervical prostaglandins (Favourable cervix/unfavourable cervix), Outcome 5 Neonatal death or serious neonatal perinatal morbidity.
15.1
15.1. Analysis
Comparison 15 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Favourable cervix/unfavourable cervix), Outcome 1 Spontaneous onset of labour.
15.2
15.2. Analysis
Comparison 15 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Favourable cervix/unfavourable cervix), Outcome 2 Induction of labour.
15.3
15.3. Analysis
Comparison 15 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Favourable cervix/unfavourable cervix), Outcome 3 Caesarean section.
15.4
15.4. Analysis
Comparison 15 Amniotic membranes sweeping versus intravenous oxytocin +/‐ amniotomy (Favourable cervix/unfavourable cervix), Outcome 4 Maternal death or serious morbidity.
17.1
17.1. Analysis
Comparison 17 Amniotic membranes sweeping versus vaginal/oral misoprostol (Favourable cervix/unfavourable cervix), Outcome 1 Caesarean section.
18.1
18.1. Analysis
Comparison 18 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping (Favourable cervix/unfavourable cervix), Outcome 1 Induction of labour.
18.2
18.2. Analysis
Comparison 18 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping (Favourable cervix/unfavourable cervix), Outcome 2 Caesarean section.
18.3
18.3. Analysis
Comparison 18 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping (Favourable cervix/unfavourable cervix), Outcome 3 Spontaneous vaginal birth.
18.4
18.4. Analysis
Comparison 18 One frequency of amniotic membranes sweeping versus another frequency of amniotic membrane sweeping (Favourable cervix/unfavourable cervix), Outcome 4 Maternal death or serious morbidity.
19.1
19.1. Analysis
Comparison 19 Amniotic membranes sweeping versus mechanical methods (Favourable cervix/unfavourable cervix), Outcome 1 Neonatal death or serious neonatal perinatal morbidity.
20.1
20.1. Analysis
Comparison 20 Amniotic membranes sweeping versus no treatment/sham‐ sensitivity analysis, Outcome 1 Spontaneous onset of labour‐sensitivity analysis.
20.2
20.2. Analysis
Comparison 20 Amniotic membranes sweeping versus no treatment/sham‐ sensitivity analysis, Outcome 2 Induction of labour‐ sensitivity analysis.
20.3
20.3. Analysis
Comparison 20 Amniotic membranes sweeping versus no treatment/sham‐ sensitivity analysis, Outcome 3 Caesarean section‐sensitivity analysis.
20.4
20.4. Analysis
Comparison 20 Amniotic membranes sweeping versus no treatment/sham‐ sensitivity analysis, Outcome 4 Spontaneous vaginal birth‐sensitivity analysis.
20.5
20.5. Analysis
Comparison 20 Amniotic membranes sweeping versus no treatment/sham‐ sensitivity analysis, Outcome 5 Maternal death or serious morbidity ‐ sensitivity analysis.
20.6
20.6. Analysis
Comparison 20 Amniotic membranes sweeping versus no treatment/sham‐ sensitivity analysis, Outcome 6 Neonatal death or serious neonatal perinatal morbidity ‐ sensitivity analysis.
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References

References to studies included in this review

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McColgin 1990b {published data only}
    1. McColgin SW, Hampton HL, McCaul JF, Howard PR, Andrew ME, Morrison JC. Stripping of membranes at term: can it safely reduce the incidence of post‐term pregnancies?. Obstetrics & Gynecology 1990;76:678‐80. - PubMed
McColgin 1993 {published data only}
    1. McColgin SW, Bennet WA, Roach H, Cowan BD, Martin JN, Morrison JC. Parturitional factors associated with membrane stripping. American Journal of Obstetrics and Gynecology 1993;169:71‐7. - PubMed
Netta 2002 {published data only}
    1. Netta D, Visintainer P, Bayliss P. Does cervical membrane stripping increase maternal colonization of group B streptococcus?. American Journal of Obstetrics and Gynecology 2002;187(6):S221.
Parlakgumus 2014 {published data only}
    1. Parlakgumus HA, Yalcinkaya C, Haydardedeoglu B, Tarim E. The impact of sweeping the membranes on cervical length and labor: a randomized clinical trial. Ginekologia Polska 2014;85(9):682‐7. - PubMed
Putnam 2011 {published data only}
    1. Putnam K, Magann EF, Doherty DA, Poole AT, Magann MI, Warner WB, et al. Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks. International Journal of Women's Health 2011;3(1):287‐94. - PMC - PubMed
Ramya 2015 {published data only}
    1. Ramya V, Ghose S, Pallavee P. Membrane sweeping for vaginal birth after caesarean section and its outcome ‐ a comparative study. Journal of Clinical and Diagnostic Research 2015;9(8):QC01‐3. - PMC - PubMed
Saichandran 2015 {published data only}
    1. Saichandran S, Arun A, Samal S, Palai P. Efficacy and safety of serial membrane sweeping to prevent post term pregnancy: a randomised study. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2015;4(6):1882‐6.
Salamalekis 2000 {published data only}
    1. Salamalekis E, Vitoratos N, Kassanos D, Loghis C, Batalias L, Panayotopoulos N, et al. Sweeping of the membranes versus uterine stimulation by oxytocin in nulliparous women. Gynecologic and Obstetric Investigation 2000;49:240‐3. - PubMed
Salmanian 2012 {published data only}
    1. Salmanian R, Khayamzadeh M. Prostaglandin & stripping in ripening of cervix and shortening of labor in post date pregnancies. International Journal of Gynecology and Obstetrics 2012;119(Suppl 3):S811.
Tannirandorn 1999 {published data only}
    1. Tannirandorn Y, Jumrustanasan T. A comparative study of membrane stripping and nonstripping for induction of labor in uncomplicated term pregnancy. Journal of the Medical Association of Thailand 1999;82(3):229‐32. - PubMed
Ugwu 2014 {published data only}
    1. Ugwu EO, Obi SN, Iferikigwe ES, Dim CC, Ezugwu FO. Membrane stripping to prevent post‐term pregnancy in Enugu, Nigeria: a randomized controlled trial. Archives of Gynecology and Obstetrics 2014;289(1):29‐34. - PubMed
Weissberg 1977 {published data only}
    1. Weissberg SM, Spellacy WN. Membrane stripping to induce labour. Journal of Reproductive Medicine 1977;19(3):125‐7. - PubMed
Wiriyasirivaj 1996 {published data only}
    1. Wiriyasirivaj B, Vutyavanich T, Ruangsri R. A randomized controlled trial of membrane stripping at term to promote labor. Obstetrics & Gynecology 1996;87:767‐70. - PubMed
Wong 2002 {published data only}
    1. Wong SF, Hui SK, Choi H, Ho LC. Does sweeping of membranes beyond 40 weeks reduce the need for formal induction of labour?. BJOG: an international journal of obstetrics and gynaecology 2002;109:632‐6. - PubMed
Yaddehige 2015 {published data only}
    1. Yaddehige SS, Kalansooriya HD, Rameez MF. Comparison of cervical massage with membrane sweeping for pre‐induction cervical ripening at term‐ A randomized control trial. Sri Lanka Journal of Obstetrics and Gynaecology 2015;37(Suppl 1):5‐6, Abstract no: OP 10.
    1. Yaddehige SS, SLCTR/2014/001. Comparison of cervical massage with membrane sweeping for pre‐induction cervical ripening at term‐ a randomized controlled trial. slctr.lk/trials/184 (first received 9 January 2014).
Yasmeen 2014 {published data only}
    1. Yasmeen A, Malik AM. Outcome of sweeping membrane within 48 hours in the induction of labour in multigravidae. Pakistan Journal of Medical and Health Sciences 2014;8(4):876‐81.
Yildirim 2010 {published data only}
    1. Yildirim G, Gungorduk K, Idem O, Aslam H, Ceylan Y. Membrane sweeping. Journal of Maternal‐Fetal and Neonatal Medicine 2008;21(Suppl 1):36. - PubMed
    1. Yildirim G, Gungorduk K, Karadag OI, Aslan H, Turhan E, Ceylan Y. Membrane sweeping to induce labor in low‐risk patients at term pregnancy: a randomised controlled trial. Journal of Maternal‐Fetal and Neonatal Medicine 2010;23(7):681‐7. - PubMed
Zamzami 2014 {published data only}
    1. Zamzami TY, Al Senani NS. The efficacy of membrane sweeping at term and effect on the duration of pregnancy: a randomized controlled trial. Journal of Clinical Gynecology and Obstetrics 2014;3(1):30‐4.

References to studies excluded from this review

Al‐Harmi 2015 {published data only}
    1. Al‐Harmi J, Chibber R, Fouda M, Mohammed KZ, El‐Saleh E, Tasneem A. Is membrane sweeping beneficial at the initiation of labor induction?. Journal of Maternal‐Fetal and Neonatal Medicine 2015;28(10):1214‐8. - PubMed
Bergsjo 1989 {published data only}
    1. Bergsjo P, Huang GD, Yu SQ, Gao ZZ, Bakketeig LS. Comparison of induced versus non‐induced labor in post‐term pregnancy. A randomized prospective study. Acta Obstetricia et Gynecologica Scandinavica 1989;68:683‐7. - PubMed
Day 2009 {published data only}
    1. Day L, Fleener D, Andrews J. Membrane sweeping with labor induction ‐ a randomized controlled trial. American Journal of Obstetrics and Gynecology 2009;201(6 Suppl 1):S47.
Foong 2000 {published data only}
    1. Foong L, Vanaja K, Tan G, Chua S. Effect of cervical membrane sweeping on induction of labour. Women's health into the new millennium. Women's Health ‐ into the new millennium. Proceedings of the 4th International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists; 1999 Oct 3‐6; Cape Town, South Africa. 1999:63.
    1. Foong LC, Vanaja K, Tan G, Chua S. Membrane sweeping in conjunction with labor induction. Obstetrics & Gynecology 2000;96:539‐42. - PubMed
Ifnan 2006 {published data only}
    1. Ifnan F, Jameel MB. Ripening of cervix for induction of labour by hydrostatic sweeping of membrane versus foley's catheter ballooning alone. Jcpsp, Journal of the College of Physicians & Surgeons ‐ Pakistan 2006; Vol. 16, issue 5:347‐50. - PubMed
Kaul 2004 {published data only}
    1. Kaul V, Aggarwal N, Ray P. Membrane stripping versus single dose intracervical prostaglandin gel administration for cervical ripening. International Journal of Gynecology & Obstetrics 2004;86:388‐9. - PubMed
Laddad 2013 {published data only}
    1. Laddad ML, Kshirsagar NS, Karale AV. A prospective randomized comparative study of intra‐cervical foley's catheter insertion versus PGE2 gel for pre‐induction cervical ripening. International Journal of Reproduction, Contraception, Obstetrics and Gynecology 2013;2(2):217‐20.
Park 2013 {published data only}
    1. Park KH, NCT01792375. Concurrent membrane sweeping with dinoprostone versus dinoprostone in labor induction of nulliparas at term with an unfavorable cervix. clinicaltrials.gov/ct2/show/record/NCT01792375 (first received 13 February 2013).
Park 2015 {published data only}
    1. Park KH, NCT02618096. Concurrent oxytocin with membrane sweeping versus dinoprostone pessary in labor induction of multiparous women at term. clinicaltrials.gov/ct2/show/NCT02618096 Date first recieved: 25 September 2015.
Shravage 2009 {published data only}
    1. Shravage J. Effect of sweeping of membranes at initiation of formal induction of labour ‐ a randomised controlled trial. International Journal of Gynecology & Obstetrics 2009;107(Suppl 2):S338.
Swann 1958 {published data only}
    1. Swann RD. Induction of labor by stripping membranes. Obstetrics & Gynecology 1958;11:74‐8. - PubMed
Tan 2006 {published data only}
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References to ongoing studies

Leong 2017 {published data only}
    1. Leong YS, NCT03326557. Membrane sweeping versus transcervical Foley catheter for induction of labour in women with previous caesarean delivery. https://clinicaltrials.gov/ct2/show/NCT03326557 (first received 31 October 2017).
Manidakis 1999 {published data only}
    1. Manidakis G, Sifakis S, Orfanoudaki E, Mikelakis G, Prokopakis P, Magou M, et al. Prostaglandin versus stripping of membranes in management of pregnancy beyond 40‐41 weeks. European Journal of Obstetrics & Gynecology and Reproductive Biology 1999;86:S79‐80.
Pathiraja 2014 {published data only}
    1. Pathiraja PD, SLCTR/2014/025. Induction of multiparous women at term using different methods: Prostaglandin E2 (dinopristone) vaginal gel, intracervical foley catheter insertion and sweeping of membrane: An open‐label, randomised controlled trial. slctr.lk/trials/244 (first received 9 October 2014).
Sharma 2012 {published data only}
    1. Sharma C. Induction of labor in women with previous one cesarean section: prospective double blind randomized control trial comparing the effect of mifepristone with sweeping stretching and trans‐cervical folley’s catheterization. ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=4745&EncHid=&amp... (first received 19 June 2012).
Sheffield 2018 {published data only}
    1. Sheffield JS, NCT03517696. Membrane sweeping in early labor and delivery outcomes. https://clinicaltrials.gov/ct2/show/NCT03517696 (first received 7 May 2018).
Shipman 2000 {published data only}
    1. Shipman M. The SNS trial: sweeping vs no sweeping of membranes in uncomplicated post‐date pregnancies. National Research Register http//www.update‐software.com/NRR (accessed 8 March 2000).
Turgay 2018 {published data only}
    1. Turgay B, NCT03591159. The effect of membrane sweeping on the delivery time and the need of induction in term pregnancy. https://clinicaltrials.gov/show/nct03591159 (first received 19 July 2018).

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Boulvain 2001
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