Department of Obstetrics and Gynaecology, Federal Medical Centre, Lokoja, Kogi State, Nigeria (FMCL).
Department of Obstetrics and Gynaecology, Lagos University Teaching Hospital, Lagos, Nigeria (LUTH).
J Obstet Gynaecol. 2022 Oct;42(7):3026-3032. doi: 10.1080/01443615.2022.2126752. Epub 2022 Sep 30.
There is a rising concern with increasing rates of pharmacologically induced labour and its complications. Membrane sweeping is a simple and less invasive means of initiating spontaneous labour onset. We compared the safety and efficacy of membrane sweeping. A total of 186 women (62 in each arm) were recruited at the antenatal clinic at 39 weeks. The intervention groups had membrane sweeping once and twice weekly respectively while the control arm had no membrane sweeping. They were all monitored and followed up till delivery. The trial was registered with the South Africa registry www.pactr.org (PACTR202112841108933) The incidence of prolonged pregnancy was 32.3%, 19.4% and 11.7% among the control, once-weekly, and twice-weekly groups respectively. The sweeping to the delivery interval was significantly shorter for the twice-weekly group (7.4 days) compared to once weekly (8.8 days) and the control group (10.6 days). There were significantly higher odds of spontaneous labour onset in the twice-weekly group (HR 1.53, = .029) compared to the control group (HR 0.65, = .033) and the once-weekly group using once weekly as reference. Membrane sweeping is a safe and effective means of preventing prolonged pregnancy. Twice-weekly sweeping of foetal membranes is more effective than once-weekly or no sweeping without added adverse feto-maternal outcomes.IMPACT STATEMENT There is no evidence supporting any increase in maternal or foetal morbidity suggesting that membrane sweeping is a safe procedure to offer to all low-risk pregnant women so as to initiate spontaneous labour onset. Membrane sweeping twice weekly after 39weeks for low-risk pregnant women is more effective than once weekly or no sweep with no added adverse maternal or perinatal risks. Twice-weekly membrane sweeping is encouraged in selected patients to reduce the risks associated with post-term pregnancy.
人们越来越关注药物诱导分娩及其并发症的发生率不断上升的问题。膜扫刮术是一种简单且侵袭性较小的启动自然分娩的方法。我们比较了膜扫刮术的安全性和有效性。共有 186 名孕妇（每组 62 名）在 39 周时在产前诊所入组。干预组分别每周进行一次和两次膜扫刮术，而对照组则不进行膜扫刮术。所有孕妇均接受监测并随访至分娩。该试验已在南非注册 www.pactr.org（PACTR202112841108933）。对照组、每周一次组和每周两次组的延长妊娠发生率分别为 32.3%、19.4%和 11.7%。与每周一次组（8.8 天）和对照组（10.6 天）相比，每周两次组的扫刮至分娩间隔明显更短（7.4 天）。与对照组相比（HR 0.65，=0.033）和每周一次组（HR 1.53，=0.029）相比，每周两次组自发临产的可能性显著更高。膜扫刮术是预防延长妊娠的安全有效的方法。与每周一次或不进行扫刮相比，每周两次扫刮胎膜可更有效地预防延长妊娠，且不会增加胎儿-母亲不良结局。
重要声明：目前尚无证据表明膜扫刮术会增加母亲或胎儿的发病率，这表明膜扫刮术是一种安全的操作，可用于所有低危孕妇，以启动自然分娩。对于低危孕妇，在 39 周后每周两次进行膜扫刮术比每周一次或不进行扫刮术更有效，且不会增加母亲或围产期的不良风险。在选择的患者中鼓励每周两次进行膜扫刮术，以降低与过期妊娠相关的风险。
