![]() ![]() 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. There isn’t any data to indicate that stretch and sweep increases the risk of infection to mother and baby when it’s properly performed.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. your membranes have already ruptured (your water has broken).Some women shouldn’t have a stretch and sweep.ĭoctors won’t usually perform a stretch and sweep if: But if a stretch and sweep doesn’t prove successful, a doctor may make further recommendations for inducing labor, depending on how far along you are and the health of you and your baby. The contractions are thought to “ripen” the cervix, or cause the cervix to soften so that a baby can more easily pass through the birth canal.ĭoctors intend for a stretch and sweep to stimulate labor within 48 hours. This includes contractions of the uterus that can lead to labor. Prostaglandins are hormones that are associated with labor because they cause smooth muscle contractions. A membrane sweep is intended to stimulate the release of hormones known as prostaglandins. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |