Membrane sweep effectiveness4/1/2023 maternal death or serious morbidity (aRR 0.83, 95% CI 0.57 to 1.20, 17 studies, 2749 participants, low-certainty evidence).spontaneous vaginal birth (aRR 1.03, 95% CI 0.99 to 1.07, 26 studies, 4538 participants, moderate-certainty evidence).caesareans (aRR 0.94, 95% CI 0.85 to 1.04, 32 studies, 5499 participants, moderate-certainty evidence).There may be little to no difference between groups for: induction (aRR 0.73, 95% CI 0.56 to 0.94, 16 studies, 3224 participants, low-certainty evidence).spontaneous onset of labour (average risk ratio (aRR) 1.21, 95% confidence interval (CI) 1.08 to 1.34, 17 studies, 3170 participants, low-certainty evidence).Women randomised to membrane sweeping may be more likely to experience: No trials reported on the outcomes uterine hyperstimulation with/without fetal heart rate (FHR) change, uterine rupture or neonatal encephalopathy.įorty studies (6548 participants) compared membrane sweeping with no treatment/sham Six studies (n = 1284) compared membrane sweeping with more than one intervention and were thus included in more than one comparison. Evidence certainty, assessed using GRADE, was found to be generally low, mainly due to study design, inconsistency and imprecision. Overall, the risk of bias was assessed as low or unclear risk in most domains across studies. We included 44 studies (20 new to this update), reporting data for 6940 women and their infants. Further information on women’s views is also needed. Further research is needed to confirm our review findings and to identify the ideal time for membrane sweep and whether having more than one sweep would be beneficial. While acknowledging that it may be uncomfortable, they felt the benefits outweighed the harms and most would recommend it to other women. Women reported feeling positive about membrane sweeping. Only three studies reported on women’s satisfaction with membrane sweeping. Membrane sweeping may reduce formal induction of labour. Membrane sweeping appears to be effective in promoting labour but current evidence suggests this did not, overall, follow-on to unassisted vaginal births. Similarly for the comparison between different frequencies of membrane sweeping. We found insufficient data to draw any conclusions in the studies comparing membrane sweep with intravenous oxytocin, with or without breaking the waters, or with vaginal/oral misoprostol. We also found no clear differences between the groups for caesarean section, instrumental vaginal births or serious illness or death of the mother or baby.Ĭompared with vaginal or intracervical prostaglandins (four studies involving 480 women), we found no difference in any outcomes although data were limited. Women may also be less likely to have formal induction of labour. Overall, the certainty of the evidence was found to be low.Ĭompared with no intervention or a sham sweep (40 studies involving 6548 women), allocated to membrane sweeping may be more likely to have spontaneous onset of labour, but we found no clear difference in unassisted vaginal births. Of the seven studies that reported financial funding, two studies reported funding from pharmaceutical companies. Studies compared membrane sweeping with no intervention or sham intervention, and also compared membrane sweeping with vaginal or intracervical prostaglandins, oral misoprostol, oxytocin and repeated membrane sweeping. We included 44 randomised studies that reported findings for 6940 women from a wide range of countries including high-, middle- and low-income countries. We searched for evidence on 25 February 2019. Formal induction of labour involves artificially stimulating the uterus with drugs such as prostaglandins or oxytocin or by breaking the amniotic sack that holds the baby (breaking the waters). It involves the clinician inserting one or two fingers into the lower part of the uterus (the cervix) and using a continuous circular sweeping motion to free the membrane from the lower uterus. Membrane sweeping is a relatively simple, low-cost procedure that seeks to reduce the use of formal induction of labour and it can be performed without the need for hospitalisation. The most common reason for formal induction of labour is post-term pregnancy (pregnancies that continue past 42 weeks' gestation). Most commonly, formal induction of labour is offered to women when continuing with a pregnancy is considered probably more harmful for the mother or baby than the adverse effects of induction. The aim of this Cochrane Review is to find out if membrane sweeping is a safe and effective way of inducing labour at or near term and if it is more effective than the formal methods of induction.
0 Comments
Leave a Reply.AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |