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Membrane sweeping added to formal induction method to increase the spontaneous vaginal delivery: a meta-analysis

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Background

Membrane sweeping (MS) could increase the likelihood of spontaneous labor within 48 h. However, the rationale for performing routinely an intervention with the potential to induce labor in women with an uneventful pregnancy at 38 weeks of gestation is, at least, questionable. We conducted a meta-analysis of randomized controlled trial (RCT) studies to assess evaluated the effect of MS added to formal induction method on the spontaneous vaginal delivery, compared with formal induction alone.

Methods

PubMed, Embase, Cochrane Library databases, Web of Science, and Clinical Trials were searched from their inception to March 8, 2017. We estimate summarized relative risk (RR) and 95% confidence intervals (CIs) for dichotomous outcomes. The primary outcome was vaginal delivery, and second outcomes (side effects of MS) included meconium-stained liquor, admission to the neonatal unit, instrumental delivery.

Results

Four RCTs with a total of 1377 participants were identified. The summary RR in the overall group was 1.12 (95% CI 1.05–1.18), with moderate heterogeneity (P = 0.22, I2 = 33%). The summary RR in the nulliparas’ subgroup was 1.32 (95% CI 1.18–1.48), with no heterogeneity (P = 0.79, I2 = 0%). MS did not increase the risk of side effects.

Conclusions

MS added to formal induction significantly increased vaginal delivery rates, especially in nulliparas compared with formal induction alone. Notably, there are no obvious side effects of MS. Meanwhile, more RCTs studies are needed to investigate the side effects of MS on instrumental delivery, postpartum hemorrhage, and cervical laceration.

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Authors and Affiliations

  1. Department of Obstetrics, The First Affiliated Hospital of China Medical University, No. 155 Nanjing North Street, Heping District, Shenyang, 110001, Liaoning, China

    Jing Liu, Tao Meng & Ge Zhao

  2. Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China

    Guang Song

Authors
  1. Jing Liu
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  2. Guang Song
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  3. Tao Meng
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  4. Ge Zhao
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Correspondence to Tao Meng.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Liu, J., Song, G., Meng, T. et al. Membrane sweeping added to formal induction method to increase the spontaneous vaginal delivery: a meta-analysis. Arch Gynecol Obstet 297, 623–630 (2018). https://doi.org/10.1007/s00404-017-4643-y

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  • DOI: https://doi.org/10.1007/s00404-017-4643-y

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