Membrane sweeping in conjunction with labor induction

Objective: To determine whether cervical membrane sweeping (stripping) during 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 delivery. Results: We recruited 130 nulliparas (64 sweep, 66 nonsweep) and 118 multiparas (60 sweep, 58 nonsweep). Among nulliparas who received intravaginal prostaglandin (PG) E-2 and oxytocin, those who had simultaneous sweeping had significantly shorter mean (+/- standard error of mean) induction-labor interval (13.6 +/- 1.4 Versus 17.3 +/- 1.2 hours, P = .048), lower mean maximum dose of oxytocin (6.8 +/- 0.8 versus 10.35 +/- 1.1 mU/minute, P = .01), and increased normal delivery rates (vaginal delivery 83.3% versus 58.2%, P = .01). Sweeping also had a favorable effect on nulliparas who received oxytocin 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 beneficial effect on labor and delivery, which appeared to be limited to nulliparas with unfavorable cervices who needed cervical priming with PGE,. (Obstet Gynecol 2000;96:539-42. (C) 2000 by The American College of Obstetricians and Gynecologists.).