Adjunctive membrane sweeping in Foley catheter induction of labor after one previous cesarean delivery: A randomized trial.

Abstract

To evaluate adjunctive membrane sweeping in Foley catheter labor induction for induction-to-delivery interval and maternal satisfaction in women with one previous cesarean delivery. This randomized trial was conducted from June to December 2020. Sixty-three women at term with one previous cesarean delivery, planned for labor induction with unripe cervixes (Bishop score ≤5), singleton, cephalic presentation with intact membranes and reassuring pre-induction fetal heart rate tracing were recruited. Women were randomized to membrane sweeping or no sweeping before Foley catheter induction of labor. Primary outcomes were induction-to-delivery interval (in hours) and maternal satisfaction with the birth process (assessed by a Visual Numerical Rating Scale 0-10). Induction-to-delivery intervals (hours), mean±standard deviation, were 25.2±9.8 versus 27.0±9.4 (P=0.463), and maternal satisfactions on birth process, median (interquartile range), were 8 (7-8) versus 8 (7-9) (P=0.170), for the adjunctive membrane sweeping with Foley catheter versus Foley catheter alone arms, respectively. Cesarean delivery rates were 22/32 (69%) versus 19/31 (61%) (relative risk 1.12, 95% confidence interval 0.78-1.62; P=0.603), and insertion-to-catheter removal intervals, median (interquartile range), were 15 (6.3-21.0) versus 19 (11.0-24.0) hours (P=0.065) for membrane sweeping with Foley catheter versus Foley catheter arm, respectively. Membrane sweeping before Foley catheter labor induction in women with one previous cesarean delivery and unfavorable cervixes did not improve induction-to-delivery interval and maternal satisfaction. This trial was registered with ISRCTN registry on June 11, 2020 and the first participant was recruited on June 18, 2020. (ISRCTN87387293; https://doi.org/10.1186/ISRCTN87387293).