Repeated Sweeping of Chorio-Amniotic Membranes as a Method of Induction of Labour in Term Pregnancies

Abstract

Background: Induction of labour is one of the most frequently performed obstetric interventions in term pregnancy. Membrane sweeping is a simple mechanical technique that promotes endogenous prostaglandin release and may facilitate spontaneous labour while reducing the need for formal induction. This study evaluated the effectiveness and safety of repeated membrane sweeping in term pregnancies. Methods: This prospective comparative study included 87 women with uncomplicated singleton term pregnancies at a tertiary care teaching hospital. Forty-four women underwent repeated membrane sweeping, while 43 received expectant management without membrane sweeping. Maternal characteristics, cervical ripening, labour outcomes, mode of delivery, maternal complications, and neonatal outcomes were compared using independent t-test and Chi-square test. Logistic and linear regression analyses were performed to identify independent predictors of spontaneous labour and interval to labour onset. Results: Women who underwent membrane sweeping demonstrated significantly greater improvement in Bishop score (7.52 ± 1.42 vs. 4.23 ± 1.34; P<0.001), shorter interval to labour onset (38.26 ± 7.92 vs. 74.63 ± 14.74 hours; P<0.001), shorter duration of active labour (5.48 ± 1.13 vs. 7.52 ± 1.69 hours; P<0.001), and higher rates of spontaneous labour (81.8% vs. 60.5%; OR=2.94, P=0.049). The requirement for formal induction was significantly reduced (29.5% vs. 53.5%; OR=0.37, P=0.040). Membrane sweeping independently increased the likelihood of spontaneous labour (adjusted OR=2.94; P=0.031) and reduced the interval to labour onset by 36.38 hours (P<0.001). Rates of caesarean delivery, premature rupture of membranes, neonatal birth weight, Apgar scores, and NICU admission were comparable between groups, indicating no increase in maternal or neonatal adverse outcomes. Conclusion: Repeated membrane sweeping is a safe, effective, and inexpensive mechanical method for promoting cervical ripening and spontaneous labour in term pregnancies. The findings support the incorporation of repeated membrane sweeping into routine antenatal care protocols for appropriately selected low-risk women, particularly in resource-limited settings.