Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks
Kathleen Putnam1, Everett F Magann2, Dorota A Doherty3, Aaron T Poole1, Marcia I Magann2, William B Warner1, Suneet P Chauhan41Department of Obstetrics and Gynecology, Naval Medical Center – Portsmouth, Portsmouth, Virginia, USA; 2University of Arkansas for Medical Sciences, Little Roc...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2011-08-01
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| Series: | International Journal of Women's Health |
| Online Access: | http://www.dovepress.com/randomized-clinical-trial-evaluating-the-frequency-of-membrane-sweepin-a8114 |
| _version_ | 1818557526678962176 |
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| author | Chauhan SP Warner WB Magann MI Poole AT Doherty DA Magann EF Putnam K |
| author_facet | Chauhan SP Warner WB Magann MI Poole AT Doherty DA Magann EF Putnam K |
| author_sort | Chauhan SP |
| collection | DOAJ |
| description | Kathleen Putnam1, Everett F Magann2, Dorota A Doherty3, Aaron T Poole1, Marcia I Magann2, William B Warner1, Suneet P Chauhan41Department of Obstetrics and Gynecology, Naval Medical Center – Portsmouth, Portsmouth, Virginia, USA; 2University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; 3School of Women's and Infants' Health, University of Western Australia, Perth, Australia; 4Aurora Healthcare, West Allis, Wisconsin, USABackground: Despite the widely accepted use of membrane sweeping to prevent postmaturity pregnancies, the optimal frequency for this procedure has not been established.Aim: To determine if the frequency of membrane sweeping in women with an unfavorable cervix at term results in fewer labor inductions.Methods: 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.Results: 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).Conclusion: 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.Keywords: labor induction, postmaturity pregnancy, Bishop's score, pregnancy duration |
| first_indexed | 2024-12-14T00:00:40Z |
| format | Article |
| id | doaj.art-a3dba7c2b9a547ae98863db1778a24ca |
| institution | Directory Open Access Journal |
| issn | 1179-1411 |
| language | English |
| last_indexed | 2024-12-14T00:00:40Z |
| publishDate | 2011-08-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Women's Health |
| spelling | doaj.art-a3dba7c2b9a547ae98863db1778a24ca2022-12-21T23:26:22ZengDove Medical PressInternational Journal of Women's Health1179-14112011-08-012011default287294Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeksChauhan SPWarner WBMagann MIPoole ATDoherty DAMagann EFPutnam KKathleen Putnam1, Everett F Magann2, Dorota A Doherty3, Aaron T Poole1, Marcia I Magann2, William B Warner1, Suneet P Chauhan41Department of Obstetrics and Gynecology, Naval Medical Center – Portsmouth, Portsmouth, Virginia, USA; 2University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA; 3School of Women's and Infants' Health, University of Western Australia, Perth, Australia; 4Aurora Healthcare, West Allis, Wisconsin, USABackground: Despite the widely accepted use of membrane sweeping to prevent postmaturity pregnancies, the optimal frequency for this procedure has not been established.Aim: To determine if the frequency of membrane sweeping in women with an unfavorable cervix at term results in fewer labor inductions.Methods: 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.Results: 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).Conclusion: 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.Keywords: labor induction, postmaturity pregnancy, Bishop's score, pregnancy durationhttp://www.dovepress.com/randomized-clinical-trial-evaluating-the-frequency-of-membrane-sweepin-a8114 |
| spellingShingle | Chauhan SP Warner WB Magann MI Poole AT Doherty DA Magann EF Putnam K Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks International Journal of Women's Health |
| title | Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks |
| title_full | Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks |
| title_fullStr | Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks |
| title_full_unstemmed | Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks |
| title_short | Randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks |
| title_sort | randomized clinical trial evaluating the frequency of membrane sweeping with an unfavorable cervix at 39 weeks |
| url | http://www.dovepress.com/randomized-clinical-trial-evaluating-the-frequency-of-membrane-sweepin-a8114 |
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