OUTCOME OF MEMBRANE SWEEPING IN REDUCING INDUCTION RATES IN POST- DATE PREGNANCIES

Abstract

Objective: To determine the effectiveness of membrane sweeping in reducing need for induction of labour in post-date pregnancies and to enlist types and frequencies of complications experienced with membrane sweeping.
Study Design: Randomized Control trial.
Setting and Duration of Study: The study was carried out at Department of Obstetrics and Gynaecology, Combined Military Hospital, Lahore from February 2007 to April 2008.
Patients and Methods: One hundred primi or second gravidas with uncomplicated singleton pregnancies having cephalic presentation at 40+1-5 weeks of gestation were enrolled after informed consent, and divided randomly into two groups of fifty each. Biophysical profile of 8/8 for each case was ensured. Group A underwent membrane sweeping while group B did not. All patients not having spontaneous labour were induced at 40+5 weeks. Data regarding number of patients having spontaneous labour or induction of labour was recorded. Mode of delivery either vaginal or cesarean birth was also recorded. In group A occurrence of complications i.e vaginal bleeding or leaking, discomfort, irregular pains, fever and neonatal sepsis was recorded.
Results: The difference in rate of spontaneous labour, induction rate and mode of delivery was insignificant between both the groups (p>0.05). In group A, 44% felt discomfort, 4% had bleeding per vaginum, 2% had leaking per vaginum and 28% had more than one complication. There were no cases of maternal or neonatal sepsis. Twenty percent did not have any side effects.
Conclusion: Sweeping of membranes is not effective in reducing induction rates in post dates pregnancies. It does not improve the spontaneous labour rate and there is no effect on the mode of delivery. Therefore, any potential benefits of this intervention must be balanced against risk of maternal discomfort and other adverse effects.