Effect of Sweeping of Membranes at Initiation of Formal Induction of Labour – A One Year Randomised Controlled Trial

Abstract

Background and objectives ABSTRACT To evaluate the induction to delivery interval and mode of delivery in subjects who undergo membrane sweeping at initiation of formal induction of labour. Methods Randomized controlled trial conducted at KLES Dr Prabhakar Kore Hospital and Medical Research Center, Belgaum. Patients requiring induction and willing for the same were screened for the selection criteria and included in the study. Patients were then randomized into Sweep and Nonsweep categories as per the computer generated randomization chart. In Sweep group Bishop’s score was noted and then membranes are swept before induction with cerviprime whereas, those in the Nonsweep category underwent induction with cerviprime without sweeping after noting the initial Bishop’s score. Progress of labour in active phase was monitored by WHO partogram ( 2000) . Results Sixty ( 35 nulliparas and 25 multiparas) subjects in Sweep and 60 ( 36 nulliparas and 24 multiparas) subjects in Nonsweep were analysed. Nulliparas, in sweep category, mean induction to delivery interval was 9.88±5.40hrs versus 18.88±6.83hrs in nonsweep category ( p=0.0001 ) . In multiparas the mean induction to delivery interval is 15.19±8.50hrs in Nonsweep and 8.33±6.79hrs in sweep ( p=0.0001 ) . Twenty five out of 35 nulliparas in sweep category went in for vaginal delivery ( 71.43% ) , whereas 17 out of 36 nulliparas in Nonsweep cases VIII had vaginal delivery ( 47.22%; p=0.038 ) . All multiparas in sweep group had vaginal delivery whereas 12 out of 24 in Nonsweep had vaginal delivery ( 50%; p<0.001 ) . The induction to delivery interval in nulliparas with Bishop’s score ≤4 in sweep category was 9.19±5.42hrs as compared to 14.61±4.99hrs in nonsweep ( p=0.0001 ) . Conclusions and interpretation The induction to delivery interval and vaginal delivery rates in nulliparas and multiparas is significantly less in sweep category. In nulliparas, with unfavourable cervical score the induction to delivery interval is significantly less in sweep.