Membrane sweeping added to formal induction method to increase the spontaneous vaginal delivery: a meta-analysis
- 327 Downloads
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.
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.
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.
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.
KeywordsMembrane sweeping Spontaneous vaginal delivery Meta-analysis
Compliance with ethical standards
This study was not funded.
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 1.Tan PC, Jacob R, Omar SZ (2006) Membrane sweeping at initiation of formal labor induction: a randomized controlled trial. Obstet Gynecol 107(3):569–577. https://doi.org/10.1097/01.AOG.0000200094.89388.70 CrossRefPubMedGoogle Scholar
- 3.Thiery M, Baines CJ (1989) The development of methods for inducing labor. In: Chalmers I, Enkin M, Keirse M (eds) Effective care in pregnancy and childbirth. Oxford University Press, Oxford, pp 969–980Google Scholar
- 11.Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA, Cochrane Bias Methods G, Cochrane Statistical Methods G (2011) The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343:d5928. https://doi.org/10.1136/bmj.d5928 CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Doany W, McCarty J (1997) Outpatient management of the uncomplicated postdate pregnancy with intravaginal prostaglandin E2 gel and membrane stripping. J Matern Fetal Med 6(2):71–78. https://doi.org/10.1002/(SICI)1520-6661(199703/04)6:2<71:AID-MFM2>3.0.CO;2-M PubMedGoogle Scholar
- 17.Martin JA, Hamilton BE, Sutton PD, Ventura SJ, Menacker F, Kirmeyer S, Mathews TJ (2009) Births: final data for 2006. National Center for Health Statistics, Hyattsville, pp 1–118Google Scholar
- 19.Hannah ME, Hannah WJ, Hellmann J, Hewson S, Milner R, Willan A (1992) Induction of labor as compared with serial antenatal monitoring in post-term pregnancy. A randomized controlled trial. The Canadian Multicenter Post-term Pregnancy Trial Group. N Engl J Med 326(24):1587–1592. https://doi.org/10.1056/NEJM199206113262402 CrossRefPubMedGoogle Scholar