title: Membrane sweeping in conjunction with labor induction.
abstract: OBJECTIVE
  To determine whether cervical membrane sweeping (stripping) during induction of labor is beneficial.
  
  
  METHODS
  We compared outcomes of labor after induction in pregnant women at term in a randomized trial. Women were assigned to having their membranes swept or not during induction. Outcome measures included duration of labor, maximum dose of oxytocin used, induction-labor interval, and mode of delivery.
  
  
  RESULTS
  We recruited 130 nulliparas (64 sweep, 66 nonsweep) and 118 multiparas (60 sweep, 58 nonsweep). Among nulliparas who received intravaginal prostaglandin (PG) E(2) and oxytocin, those who had simultaneous sweeping had significantly shorter mean (+/- standard error of mean) induction-labor interval (13.6 +/- 1.4 versus 17.3 +/- 1.2 hours, P =.048), lower mean maximum dose of oxytocin (6.8 +/- 0.8 versus 10.35 +/- 1.1 mU/minute, P =.01), and increased normal delivery rates (vaginal delivery 83. 3% versus 58.2%, P =.01). Sweeping also had a favorable effect on nulliparas who received oxytocin alone (mean induction-labor interval 5.8 +/- 3.1 versus 11.2 +/- 3.6 hours, P =.04; mean maximum dose 8.8 +/- 1.3 versus 16.3 +/- 1.9 mU/min, P =.01). Those differences were limited to women with unfavorable cervices. There were no differences in any outcome measures in multiparous women.
  
  
  CONCLUSIONS
  Sweeping of the membranes during induction of labor had a beneficial effect on labor and delivery, which appeared to be limited to nulliparas with unfavorable cervices who needed cervical priming with PGE(2).
authors.affiliation: Department of Obstetrics & Gynaecology, National University Hospital, Singapore, Singapore. obgflc@leonis.nus.edu.ag
authors.forename: L C
authors.initials: LC
authors.lastname: Foong
authors.forename: K
authors.initials: K
authors.lastname: Vanaja
authors.forename: G
authors.initials: G
authors.lastname: Tan
authors.forename: S
authors.initials: S
authors.lastname: Chua
mesh_terms: D000328:Adult; D015232:Dinoprostone / Q000008:administration & dosage; D005321:Extraembryonic Membranes; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D010120:Oxytocics / Q000008:administration & dosage; D010298:Parity; D010812:Physical Stimulation; D011247:Pregnancy
chemical_list: D010120:Oxytocics; D015232:Dinoprostone