Department of Obstetrics and Gynecology, Naval Medical Center - Portsmouth, Portsmouth, Virginia, USA;
Int J Womens Health. 2011;3:287-94. doi: 10.2147/IJWH.S23436. Epub 2011 Aug 19.
Despite the widely accepted use of membrane sweeping to prevent postmaturity pregnancies, the optimal frequency for this procedure has not been established.
To determine if the frequency of membrane sweeping in women with an unfavorable cervix at term results in fewer labor inductions.
This was a randomized trial of women with an unfavorable cervix (Bishop's score of ≤4) at 39 weeks randomized into three groups: control, once-weekly membrane sweeping, and twice-weekly membrane sweeping.
Between January 2005 and June 2008, 350 women were randomized into the study (groups: control [n = 116], once weekly [n = 117], and twice weekly [n = 117]). Randomization of Bishop's score was different between groups (P = 0.019), with 67%, 71%, and 83% of control, once-, and twice-weekly groups, respectively, having scores of 3-4. There was no difference in the unadjusted rate of labor induction between the groups (35% versus 27% versus 23%, P = 0.149), and after the adjustment for the randomization of Bishop's score (adjusted odds ratio [OR] = 0.73, 95% confidence interval [CI] 0.41-1.29 and OR = 0.65, 95% CI 0.36-1.18 for once- and twice-weekly groups, respectively). A Bishop's score of 3-4 at randomization was the only statistically significant factor that decreased the likelihood of induction at 41 weeks (OR = 0.42, 95% CI 0.25-0.69).
Frequency of membrane sweeping does not influence the likelihood of remaining undelivered at 41 weeks of pregnancy. The Bishop's score at around 39 weeks is the important factor as a predictor of the duration of pregnancy, and further studies would be required to determine whether membrane sweeping influences pregnancy duration.
尽管膜扫术被广泛用于预防过期妊娠，但该操作的最佳频率尚未确定。
确定足月时宫颈条件不佳（Bishop 评分≤4）的女性进行膜扫术的频率是否会减少引产。
这是一项随机试验，纳入 39 周时宫颈条件不佳（Bishop 评分≤4）的女性，分为三组：对照组、每周一次膜扫术组和每周两次膜扫术组。
2005 年 1 月至 2008 年 6 月，共纳入 350 名女性（对照组：n=116；每周一次膜扫术组：n=117；每周两次膜扫术组：n=117）。Bishop 评分的随机分组存在差异（P=0.019），对照组、每周一次膜扫术组和每周两次膜扫术组的 3-4 分评分分别为 67%、71%和 83%。三组间未校正的引产率无差异（35%、27%和 23%，P=0.149），Bishop 评分的校正后比值比（OR）也无差异[分别为 0.73（95%置信区间：0.41-1.29）和 0.65（95%置信区间：0.36-1.18]。随机分组时 Bishop 评分为 3-4 分是唯一显著降低 41 周时引产可能性的因素（OR=0.42，95%置信区间：0.25-0.69）。
膜扫术的频率并不影响妊娠 41 周时未分娩的可能性。Bishop 评分在 39 周左右是预测妊娠持续时间的重要因素，还需要进一步研究以确定膜扫术是否影响妊娠持续时间。
