Skip to main content
SpringerLink
Log in

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  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

    Article  PubMed  Google Scholar 

  2. Gabbay-Benziv R, Hadar E, Ashwal E, Chen R, Wiznitzer A, Hiersch L (2016) Induction of labor: does indication matter? Arch Gynecol Obstet 294(6):1195–1201. https://doi.org/10.1007/s00404-016-4171-1

    Article  PubMed  Google 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 969–980

    Google Scholar 

  4. Mitchell MD, Flint AP, Bibby J, Brunt J, Arnold JM, Anderson AB, Turnbull AC (1977) Rapid increases in plasma prostaglandin concentrations after vaginal examination and amniotomy. BMJ 2(6096):1183–1185

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. McColgin SW, Bennett WA, Roach H, Cowan BD, Martin JN Jr, Morrison JC (1993) Parturitional factors associated with membrane stripping. Am J Obstet Gynecol 169(1):71–77

    Article  CAS  PubMed  Google Scholar 

  6. Chard T, Gibbens GL (1983) Spurt release of oxytocin during surgical induction of labor in women. Am J Obstet Gynecol 147(6):678–680

    Article  CAS  PubMed  Google Scholar 

  7. Boulvain M, Stan C, Irion O (2005) Membrane sweeping for induction of labour. Cochrane Database Syst Rev 1:CD000451. https://doi.org/10.1002/14651858.cd000451.pub2

    Google Scholar 

  8. Hill MJ, McWilliams GD, Garcia-Sur D, Chen B, Munroe M, Hoeldtke NJ (2008) The effect of membrane sweeping on prelabor rupture of membranes: a randomized controlled trial. Obstet Gynecol 111(6):1313–1319. https://doi.org/10.1097/AOG.0b013e31816fdcf3

    Article  PubMed  Google Scholar 

  9. Ugwu EO, Obi SN, Iferikigwe ES, Dim CC, Ezugwu FO (2014) Membrane stripping to prevent post-term pregnancy in Enugu, Nigeria: a randomized controlled trial. Arch Gynecol Obstet 289(1):29–34. https://doi.org/10.1007/s00404-013-2918-5

    Article  CAS  PubMed  Google Scholar 

  10. Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 339:b2535. https://doi.org/10.1136/bmj.b2535

    Article  PubMed  PubMed Central  Google 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

    Article  PubMed  PubMed Central  Google Scholar 

  12. Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21(11):1539–1558. https://doi.org/10.1002/sim.1186

    Article  PubMed  Google Scholar 

  13. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188

    Article  CAS  PubMed  Google 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

    CAS  PubMed  Google Scholar 

  15. Foong LC, Vanaja K, Tan G, Chua S (2000) Membrane sweeping in conjunction with labor induction. Obstet Gynecol 96(4):539–542

    CAS  PubMed  Google Scholar 

  16. Al-Harmi J, Chibber R, Fouda M, Mohammed ZK, El-Saleh E, Tasneem A (2015) Is membrane sweeping beneficial at the initiation of labor induction? J Matern Fetal Neonatal Med 28(10):1214–1218. https://doi.org/10.3109/14767058.2014.947951

    Article  PubMed  Google 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 1–118

    Google Scholar 

  18. Sawai SK, O’Brien WF, Mastrogiannis DS, Krammer J, Mastry MG, Porter GW (1994) Patient-administered outpatient intravaginal prostaglandin E2 suppositories in post-date pregnancies: a double-blind, randomized, placebo-controlled study. Obstet Gynecol 84(5):807–810

    CAS  PubMed  Google 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

    Article  CAS  PubMed  Google Scholar 

  20. Takahashi T, Marcus B, Scheerer RG, Katz M (1991) A new model for objective assessment of cervical ripening: the effect of prostaglandin E2 and prelabor contractility. Am J Obstet Gynecol 164(4):1115–1118

    Article  CAS  PubMed  Google Scholar 

  21. Casey C, Kehoe J, Mylotte MJ (1994) Vaginal prostaglandins for the ripe cervix. Int J Gynaecol Obstet 44(1):21–26

    Article  CAS  PubMed  Google Scholar 

  22. Greer IA, McLaren M, Calder AA (1990) Vaginal administration of PGE2 for induction of labor stimulates endogenous PGF2 alpha production. Acta Obstet Gynecol Scand 69(7–8):621–625

    Article  CAS  PubMed  Google Scholar 

  23. Bakker R, Pierce S, Myers D (2017) The role of prostaglandins E1 and E2, dinoprostone, and misoprostol in cervical ripening and the induction of labor: a mechanistic approach. Arch Gynecol Obstet 296(2):167–179. https://doi.org/10.1007/s00404-017-4418-5

    Article  CAS  PubMed  Google Scholar 

  24. Keirse MJ, Thiery M, Parewijck W, Mitchell MD (1983) Chronic stimulation of uterine prostaglandin synthesis during cervical ripening before the onset of labor. Prostaglandins 25(5):671–682

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

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
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Guang Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tao Meng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ge Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tao Meng.

Ethics declarations

Funding

This study was not funded.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

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

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 623 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

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

Keywords

Search

Navigation