Membrane sweeping in conjunction with labor induction

Objective: To determine whether cervical membrane sweeping (stripping) duri ng 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 deliv ery. Results: We recruited 130 nulliparas (64 sweep, 66 nonsweep) and 118 multip aras (60 sweep, 58 nonsweep). Among nulliparas who received intravaginal pr ostaglandin (PG) E-2 and oxytocin, those who had simultaneous sweeping had significantly shorter mean (+/- standard error of mean) induction-labor int erval (13.6 +/- 1.4 Versus 17.3 +/- 1.2 hours, P = .048), lower mean maximu m dose of oxytocin (6.8 +/- 0.8 versus 10.35 +/- 1.1 mU/minute, P = .01), a nd increased normal delivery rates (vaginal delivery 83.3% versus 58.2%, P = .01). Sweeping also had a favorable effect on nulliparas who received oxy tocin 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. Conclusion: Sweeping of the membranes during induction of labor had a benef icial effect on labor and delivery, which appeared to be limited to nullipa ras with unfavorable cervices who needed cervical priming with PGE,. (Obste t Gynecol 2000;96:539-42. (C) 2000 by The American College of Obstetricians and Gynecologists.).