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Evidence summaries

Membrane Sweeping for Induction of Labour

Sweeping of membranes for induction of labour reduces the use of more formal methods of induction in women at term, and at weeks 41 reduces the risk of post-term pregnancy. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 44 trials and 6 940 women. Compared with no treatment/sham, membrane sweeping increased spontaneous onset of labour (average risk ratio [aRR] 1.21, 95% CI 1.08 to 1.34, 17 studies, n=3170). Risk of caesarean section (aRR 0.94, 95% CI 0.85 to 1.04, 32 studies, n=5499), spontaneous vaginal birth (aRR 1.03, 95% CI 0.99 to 1.07, 26 studies, n=4538), maternal death or serious morbidity (aRR 0.83, 95% CI 0.57 to 1.20, 17 studies, n=2749), and neonatal perinatal death or serious morbidity (aRR 0.83, 95% CI 0.59 to 1.17, 18 studies, n=3696) were similar between groups. There were little or no difference fot those outcomes when sweeping of the membranes were compared with with vaginal/intracervical prostaglandins (4 trials, n= 480).

A meta-analysis 3 included 7 studies with a total of 2252 participants. The meta-analysis assessed efficacy and the safety of membrane sweeping in promoting spontaneous labour and reducing a formal induction of labour for postmaturity. Membrane sweeping was advantageous in promoting spontaneous labour (RR 1.20, 95% CI 1.133 to 1.282, p = <.001), and reducing the formal induction of labour for postmaturity (RR 0.523, 95% CI:0.409- to .669, p = <.001).

    References

    • Finucane EM, Murphy DJ, Biesty LM et al. Membrane sweeping for induction of labour. Cochrane Database Syst Rev 2020;(2):CD000451. [PubMed]
    • Avdiyovski H, Haith-Cooper M, Scally A. Membrane sweeping at term to promote spontaneous labour and reduce the likelihood of a formal induction of labour for postmaturity: a systematic review and meta-analysis. J Obstet Gynaecol 2019;39(1):54-62. [PubMed]

Primary/Secondary Keywords