Effectiveness and safety of membrane sweeping in the prevention of post-term pregnancy: a randomised controlled trial

Salau, J O; Onile, Temitope G.; Musa, A O; Olorunfemi, Gbenga; Adewole, A A; Olumodeji, Ayokunle Moses

doi:10.1080/01443615.2022.2126752

Cited by 3 publications

(12 citation statements)

References 16 publications

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“…For instance, Iferikigwe's study conducted in Enugu State, Nigeria, [45] demonstrated that 11.3% of patients who had their membranes swept subsequently required elective labor induction for postdate pregnancy, compared to 37.7% of patients whose membranes were not swept. Similarly, a study by Nyamzi and colleagues in Abuja, Nigeria [46], reported significantly lower rates of elective labor induction in the membrane sweep group (12.4%) compared to the control group (37.1%). However, it's worth noting that Iferikigwe and co-workers employed repeated membrane sweeping, unlike the single membrane sweep approach utilized in this study and the Abuja study.…”

Section: Discussionmentioning

confidence: 79%

“…A study in Nigeria by Iferikigwe et al [45] found that only 11.3% of patients who underwent membrane sweeping subsequently required elective labor induction for postdate pregnancy, compared to 37% in the control group. More recent studies including one conducted in Abuja, Nigeria, have reported similar results [46][47][48]. However, the study by Iferikigwe et al involved serial membrane sweeping, while the Abuja study employed a single fetal membrane sweep.…”

Section: Effect Of Membrane Sweeping On the Incidence Of Elective Lab...mentioning

confidence: 87%

“…It is also important to note that in this particular study, Bishop scores for the control group were determined before the inclusion of participants. This approach differed from some other studies that opted not to assess Bishop scores beforehand due to concerns that the procedure might stimulate the release of prostaglandins, potentially influencing cervical ripening and uterine contractions [41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57]. In this study, assessing the Bishop score was deemed necessary to control for and mitigate any potential bias or influence it might have on the study's outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…The higher rate of spontaneous labor observed in our study compared to previous research may be attributed to our departmental protocol, which schedules labor induction at 41+3 weeks of gestation, in contrast to the previous study where induction occurred at 40 weeks of gestation. Nyamzi and colleagues in Nigeria [46] noted that inducing labor at 41+3 weeks was well-received by both patients and clinicians. In their study, they found that following membrane sweeping, 87.6% of women went into spontaneous labor compared to 62.9% in the control group.…”

Section: Discussionmentioning

confidence: 99%

“…This distinction could contribute to the significantly favorable outcomes we observed in our study. It is also crucial to emphasize, as previously argued by Nyamzi et al [46], that when analyzing the results of studies involving single or serial membrane sweepings from 41 weeks onwards, the procedure is typically performed as an outpatient intervention without the immediate goal of labor induction. This practice is justified by the fact that perinatal morbidity and mortality begin to increase even before 41 weeks of gestation [46].…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Single Fetal Membrane Sweeping in Reducing Elective Labor Induction for Postdate Pregnancies (38+0 to 40+6 Weeks): A Randomized Controlled Trial

Ehikioya,

Nwachukwu,

Okobi

2024

Cureus

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Background: Postdate pregnancy is characterized by a heightened risk for both maternal and perinatal complications. Owing to the risks, clinicians frequently turn to elective labor induction as a management strategy for postdate pregnancies. However, patients are increasingly informed and apprehensive about this approach and its associated risks. This has prompted a search for alternative management methods that may encourage spontaneous labor in pregnant women. One such approach is the use of fetal membrane sweeping, a method known to increase the likelihood of spontaneous labor onset. Yet, it remains unclear whether a single fetal membrane sweeping procedure can effectively reduce the need for elective labor induction in postdate pregnancies while minimizing risks to both the mother and fetus.Objectives: The primary objective of this study was to assess the efficacy of a single fetal membrane sweeping procedure conducted between 38+0 and 40+6 weeks of gestation in reducing the rate of elective labor induction among postdate pregnancies at Central Hospital Benin City, Nigeria. Secondary objectives included evaluating the impact of membrane sweeping on maternal and perinatal outcomes.Methodology: This open-label superiority randomized controlled study was carried out from June 2020 to March 2021, following ethical approval from the Hospital Management Board (HMB). One hundred and forty eligible participants, without contraindications to vaginal delivery, were randomly assigned to one of two groups. The first group received a single fetal membrane sweeping procedure between 38+0 and 40+6 weeks of gestation, while the control group underwent vaginal examination only to assess the Bishop score. Participants were monitored until delivery. Data analysis was performed. Results were considered statistically significant at p < 0.05.Results: The implementation of a single fetal membrane sweeping procedure effectively reduced the incidence of elective labor induction. Specifically, the membrane sweep group exhibited a significantly lower rate of elective labor induction compared to the control group (9.0% vs. 27.1%; p=0.0083). Moreover, a substantial proportion of the treatment group (91.4%) experienced spontaneous labor, while the control group reported a rate of 72.9%. The difference was statistically significant (p=0.0054). Notably, the control group exhibited a significantly longer mean time interval from recruitment to delivery (10.67±3.51 days) than the membrane sweeping group (3.64±4.123 days; p<0.05). Also, postdate women in the membrane sweep group were less likely to require cervical ripening with Foley's catheter than those in the control group (33.3% vs. 100%; RR: 0.33 (0.11-1.03); p=0.0057). Still, maternal satisfaction was significantly higher in the membrane-sweeping group (p<0.01). No significant differences were noted across the groups in maternal and neonatal outcomes. Conclusion:In low-risk term pregnancies, a single fetal membrane sweeping procedure is a superior alternative to no membrane sweeping in r...

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Section: Discussionmentioning

confidence: 79%

Section: Effect Of Membrane Sweeping On the Incidence Of Elective Lab...mentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Effectiveness of Single Fetal Membrane Sweeping in Reducing Elective Labor Induction for Postdate Pregnancies (38+0 to 40+6 Weeks): A Randomized Controlled Trial

Ehikioya,

Nwachukwu,

Okobi

2024

Cureus

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Membrane sweeping at term to promote spontaneous labor and reduce the likelihood of formal labor induction for prolonged pregnancy, in South Asia and the world: A meta‐analysis

Jayasundara,

Jayawardane,

Denuwara

et al. 2024

Intl J Gynecology & Obste

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BackgroundMembrane sweeping promotes the spontaneous onset of labor, reducing the need for formal labor induction. In addition to the safety profile, membrane sweep is a cost‐effective measure in a low‐resource setting like South Asia.ObjectivesTo the best of our knowledge, previous reviews and meta‐analyses have not explored the timing and frequency of membrane sweeping or its association with the period of gestation (POG) and parity. Additionally, the results should be interpreted with caution due to the inclusion of older studies and the analyses conducted regardless of ethnicity in previous literature. We addressed these gray areas in the current study to fill the research gap.Search StrategyWe searched PubMed, Google Scholar, Science Direct, and Cochrane Reviews. Study selection was performed using the semi‐automated tool Rayyan.Selection CriteriaThe selection criteria for this study encompassed the inclusion of randomized controlled trials (RCTs) published in English between January 2010 and May 2023, with accessible full‐text articles. The focus was on low‐risk pregnant women carrying a single fetus in a cephalic presentation at term (37–42 weeks) gestation, confirmed by reliable methods. Essential data for relative risk (RR) and 95% confidence interval (CI) calculation must be present.Data Collection and AnalysisThe Cochrane risk‐of‐bias (RoB2) tool and funnel plots were used to assess bias. Review Manager (RevMan) 5.4 version was used for analysis. The Mantel–Haenszel statistics and random effects were used to calculate the overall effect of risk ratio with a 95% confidence interval. Study heterogeneity was calculated using the I2 statistic. Two subgroups were used in the analysis: South Asia and the rest of the world.Main ResultsA total of 13 RCTs with 2599 participants were analyzed. Overall, membrane sweep effectively reduced formal IOL with an effect size of 2.43 (95% CI: 1.51–3.91). It also promoted spontaneous labor with an effect size of 1.71 (95% CI: 1.15–2.55). In the South Asian subgroup, membrane sweeping significantly promoted the spontaneous onset of labor with an overall effect of 1.85 (95% CI: 1.37–2.51), and in the rest of the world subgroup, membrane sweeping significantly reduced formal labor induction with an overall effect of 1.93 (95% CI: 1.33–2.82). The pooled effects were significant in mulipara with a POG ≥40 W in the South Asian subgroup.ConclusionsMembrane sweeping effectively reduces the need for formal labor induction and promotes spontaneous labor. This may be particularly relevant in South Asian populations where a disproportionate ethnic contribution to stillbirth rates is noted. Due to the limited number of RCTs addressing the factors and study methodology heterogeneity, we had limited data in some subgroup analyses. Therefore, we encourage more RCTs and meta‐analyses on POG, parity, timing and frequency of membrane sweeping, and ethnic differences.

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Postponed Pregnancy in Modern Obstetrics

Kozar,

Kalinovska

2023

CAOS

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Delayed pregnancy is one of the key problems of modern obstetrics that requires attention and study. The article examines the current state of research and approaches to the diagnosis and treatment of this phenomenon, provides an analysis of literature data on risk factors for late pregnancy, features of the course of pregnancy and childbirth, complications during childbirth, and assessment of the condition of newborns.In particular, many authors pay attention to the increase in cases of delayed pregnancy in modern society and its possible causes. Particular attention is paid to the risk factors that may contribute to this condition, such as the age of the mother, the presence of chronic diseases, genetic aspects and other factors that may determine the occurrence of this condition.An analysis of the methods of diagnosing late pregnancy, including modern technologies that allow timely detection of this condition and determination of its causes, was also carried out. In the literature, the authors note the role of ultrasound examination and its eﬀ ectiveness in detecting and studying late pregnancy. Current approaches to the management of late pregnancy, such as drug therapy, surgery, and supportive care, are highlighted.Most authors emphasize the importance of an individualized approach to each case of late pregnancy and the determination of optimal treatment that takes into account both medical and psychosocial aspects.It has been shown that late pregnancy signiﬁ cantly aﬀ ects the intrauterine condition of the fetus and the development of diseases in the early neonatal period, therefore the authors discuss possible ways to prevent such consequences, as well as the importance of postpartum care and monitoring.The article highlights the perspective of further research into this pathology and the importance of developing new technologies and approaches to improve the diagnosis and treatment of delayed pregnancy in the future. The role of biomarkers and genetic tests for early diagnosis and prediction of late pregnancy is highlighted. Overall, the article makes an important contribution to the understanding and management of late pregnancy in modern obstetrics.

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Effectiveness and safety of membrane sweeping in the prevention of post-term pregnancy: a randomised controlled trial

Cited by 3 publications

References 16 publications

Effectiveness of Single Fetal Membrane Sweeping in Reducing Elective Labor Induction for Postdate Pregnancies (38+0 to 40+6 Weeks): A Randomized Controlled Trial

Effectiveness of Single Fetal Membrane Sweeping in Reducing Elective Labor Induction for Postdate Pregnancies (38+0 to 40+6 Weeks): A Randomized Controlled Trial

Membrane sweeping at term to promote spontaneous labor and reduce the likelihood of formal labor induction for prolonged pregnancy, in South Asia and the world: A meta‐analysis

Postponed Pregnancy in Modern Obstetrics

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