Is membrane sweeping beneficial at the initiation of labor induction?

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) E-2, 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. Conclusion: Membrane sweeping, has beneficial effects on labor and delivery, which is limited to nulliparas with unfavorable cervix requiring PGE(2) or Oxytocin alone.