Effectiveness of multiple versus once-only membrane sweeping at term in preventing prolonged pregnancy: A randomised controlled trial

Abstract

BackgroundBetween 4 and 18% of pregnancies are prolonged. Prolonged pregnancy is associated with adverse maternal and perinatal outcomes. ObjectivesTo compare the effectiveness of once-only versus multiple (weekly) membrane sweeping in reducing the incidence of prolonged pregnancy. Materials and methods: This randomised controlled trial was conducted over a two-year period, from January 2018 to December 2019, at the Federal Medical Centre and Diete-Koki Memorial Hospital, both in Yenagoa, Bayelsa State, Nigeria. Seven hundred and eighty-six women were equally randomized into two groups: once-only and multiple membrane sweeping, initiated at 39 weeks’ gestational age, but 742 women were included in the analysis. Data obtained was analysed using the Statistical Package for Service Solutions for Windows® version 20, SPSS Inc.; Chicago, USA). Associations between categorical independent and outcome variables were assessed, where applicable, using Chi square test at 95% confidence interval. A P-value of <0.05 was considered statistically significant. ResultsThere were no statistically significant differences between the two groups in terms of time interval between membrane sweeping and delivery (P = 0.85), spontaneous onset of labour (P = 0.21), induction of labour (P = 0.21) and Caesarean section rate (P = 0.68). The maternal complications of vaginal bleeding and pre-labour rupture of membranes following membrane sweeping in the two groups were also comparable (P = 0.45 each). All the women were satisfied and membrane sweeping was acceptable to all of them. ConclusionOnce-only membrane sweeping at 39 weeks’ gestational age is as effective as multiple membrane sweeping for the prevention of prolonged pregnancy. Multiple membrane sweeping does not confer any added advantage/benefit over a single sweep.