title: Is membrane sweeping beneficial at the initiation of labor induction?
abstract: OBJECTIVE
  To determine whether cervical membrane sweeping during labor induction is beneficial.
  
  
  METHODS
  Outcomes of labor after induction in pregnant women at term were compared in a randomized trial. Women were assigned to having their membranes "swept" or "not swept" at the initiation of labor induction.
  
  
  RESULTS
  We recruited a total of 870 women of which 70 were excluded. There were 400 nullipara (Group A) [198 "swept", 202 "not swept"] and 400 multiparas (Group B) (201 "swept" and 199 "not swept"]. Among group A who received intravaginal prostaglandin (PG) E2, those who had simultaneous sweeping had significantly shorter mean induction-labor interval (12.9 ± 1.3 versus 16.2 ± 1.1 hours, p = 0.046), lower mean dose of oxytocin (6.6 ± 0.6 versus 10.11 ± 1.4 mU/minute, p = 0.01), and increased normal delivery rates (vaginal delivery 82.8% versus 58.6%, p = 0.01). Sweeping also had a favorable effect on nulliparas who had ARM and received oxytocin alone (mean induction-labor interval 5.9 ± 2.9 versus 10.9 ± 2.6 hours p = 0.04, mean maximum dose of oxytocin 9.8 ± 1.1 versus 15.2 ± 1.1 mU/min, p = 0.01). These results were restricted to women with unfavorable cervix in Group A those who had membrane sweeping.
  
  
  CONCLUSIONS
  Membrane sweeping, has beneficial effects on labor and delivery, which is limited to nulliparas with unfavorable cervix requiring PGE2 or Oxytocin alone.
authors.affiliation: a Department of Obstetrics and Gynecology, Faculty of Medicine , Kuwait University , Kuwait and.
authors.forename: Jehad
authors.initials: J
authors.lastname: Al-Harmi
authors.forename: Rachana
authors.initials: R
authors.lastname: Chibber
authors.forename: Mohamed
authors.initials: M
authors.lastname: Fouda
authors.forename: Zeinab K
authors.initials: ZK
authors.lastname: Mohammed
authors.forename: Eyad
authors.initials: E
authors.lastname: El-Saleh
authors.forename: Asiya
authors.initials: A
authors.lastname: Tasneem
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000187:drug effects*; D015232:Dinoprostone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000379:methods*; D007743:Labor, Obstetric; D017063:Outcome Assessment, Health Care; D010121:Oxytocin / Q000627:therapeutic use*; D011247:Pregnancy
chemical_list: D010121:Oxytocin; D015232:Dinoprostone
keywords: Membranes “swept”; membranes “not swept”; multipara; nullipara; outcome measures