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Objective To determine whether sweeping of the membranes is an effective method of induction of labour in women with prolonged pregnancy. Design Randomized controlled trial. Setting A district maternity hospital. Subjects 65 women attending an antenatal clinic; 33 randomized to sweeping of the membranes and 32 to a control group. Main outcome measure Proportion of women achieving spontaneous labour. Results Spontaneous labour occurred more often in the sweeping of the membranes group than in the control group (25/33 (76%) vs 12/32 (38%); odds ratio (OR) 4.65; 95% confidence interval (CI) 1.75 to 12.31; P= 0.002). In addition a greater proportion of women in the sweeping group had a cervical dilatation of 4 cm or more at the first vaginal examination in the labour ward (16/33 (49%) vs 5/32 (16%); OR 4.39; 95% CI 1.56 to 12.32; P= 0.005). There were fewer maternal infections in the sweeping group (0/33 vs 4/32 (12%); OR 0.12; 95% CI 0.02 to 0.88; P= 0.04). There were no differences in the type of analgesia used in labour, the mode of delivery or neonatal outcome. Conclusions Sweeping of the membrances is an effective method of induction of labour in women with prolonged pregnancy.

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Forty women at or past term with an unfavourable cervix (Bishop's score 5 4) who required induction of labour were allocated at random to a Foley catheter plus extra-amniotic water or to a Foley catheter alone to compare the effects of the two methods in preparation of the unfavourable cervix for induction of labour. Hydrostatic sweeping of the membranes resulted in a greater increase in Bishop's score (difference between means 2.7, 95 per cent confidence interval, (C.I.) 16-34, P < 0.001). a greater increase in cervical dilatation (difference between means 1.2, C.I. 0.4-1.9, P

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