Does sweeping of membranes in nulliparous women reduce the need for formal induction of labor?

Objective: To evaluate the effectiveness of sweeping of the membranes in nulliparous women to reduce the need for a formal induction of labor. Design: A randomized controlled clinical trial. Place and duration of study: The study was conducted in the Gynae unit 1 of Jinnah Hospital Complex. Lahore, from April 2001to March 2003. Patients and methods: 100 nulliparous women attending the antenatal clinic at 39 weeks of gestation were randomly allocated for the study. 50 women were randomized to sweeping of membranes and 50 to control group. Their outcome measures in terms of proportion of women achieving spontaneous labor, duration of labor and bishop score at the time of admission to the hospital were assessed. Results: Spontaneous labor occurred more often in the sweeping of the membranes group than in the control group (38/50(76%) vs. 19/50(38%) P = 0.002). In addition a greater proportion of women in the sweeping group had a cervical dilatation of 4 cm or more at the first vaginal examination in the labo r ward (25/50 (49%) vs. 8/50 (16%) P = 0.005. Women allocated to sweeping showed a trend towards having a shorter randomization-delivery interval: 9.4 days vs. 10.6 days in the controls P = 0.087. The need for induction of labor was significantly reduced in those women who underwent sweeping (11% vs26% P = 0.004). Conclusion: Sweeping of membranes in nulliparous women at 39weeks of gestation significantly decreases the number that will reach 41 weeks of gestation.