A RANDOMIZED CONTROLLED TRIAL OF MEMBRANE STRIPPING AT TERM TO PROMOTE LABOR

Objective: To determine the effectiveness of membrane stripping at ter m to promote the onset of labor. Methods: One hundred twenty gravidas at 38 weeks' gestation, who were attending an antenatal clinic and pla nned to deliver at Maharaj Nakorn Chiang Mai University Hospital in no rthern Thailand, were assigned randomly to one of two groups. One grou p had weekly pelvic examinations only, and the other also had membrane stripping, beginning at 38 weeks' gestation and continuing until the onset of labor or until 42 completed weeks' gestation. Outcome measure s included the proportion of patients who delivered within 7 days afte r the first examination, Bishop scores among those who did not deliver , days from the first examination to delivery, incidence of postterm p regnancy, and maternal and fetal complications. Results: Twenty-five o f 61 patients (41%) assigned to membrane stripping delivered within 1 week, compared with 12 of 59 controls (20.3%), a statistically signifi cant difference (P = .014). There was also a statistically significant difference (P = .013, Mann-Whitney U test) in the Bishop scores among those who did not deliver within 1 week (4 +/- 2.5 versus 2.6 +/- 1.7 in the study and control groups, respectively). A significant differe nce was also observed with respect to the mean number of days to deliv ery (8.8 +/- 6.7 versus 13.6 +/- 7.5, respectively; P < .001). The inc idence of postterm pregnancy was one of 61 (1.6%) and three of 59 (5.1 %) in the stripping and control groups, respectively. No significant d ifferences were observed in maternal and fetal complications. Conclusi on: Membrane stripping is safe and effective in promoting the onset of labor at term.