If you must induce, sweep first.A study was published in the March 2006 issue of Obstetrics and Gynecology obstetrics and gynecology Medical and surgical specialty concerned with the management of pregnancy and childbirth and with the health of the female reproductive system. investigating the possible benefits of membrane sweeping (also called stripping the membranes) in conjunction with formal medical induction. Two hundred seventy-four women were randomly assigned to receive membrane sweeping or no membrane sweeping at initiation of formal labor induction with either Cervadil[R] (dinoprostone pessary pessary /pes·sa·ry/ (pes´ah-re) 1. an instrument placed in the vagina to support the uterus or rectum or as a contraceptive device. 2. a medicated vaginal suppository. ) or amniotomy (rupture of membranes Rupture of membranes (ROM) is a term used during pregnancy to describe a rupture of the amniotic sac at the onset of, or during, labor. This is colloquially known as "breaking water". ). Outcome measures included mode of birth (vaginal or cesarean cesarean /ce·sar·e·an/ (se-zar´e-an) see under section. ce·sar·e·an or cae·sar·e·an or cae·sar·i·an or ce·sar·i·an adj. Of or relating to a cesarean section. ), induction-to-birth time, Cervadil[R] dose, any pitocin use and duration of pitocin use in labor, visual score for pain associated with sweeping, and visual score for satisfaction with the birth process. Women who had their membranes swept prior to induction had a higher rate of spontaneous vaginal birth (69% compared to 56%), shorter induction to birth time (mean of 14 hours versus 19 hours), and required pitocin less often (46% versus 59%). The conclusion of the study is that "Membrane sweeping at initiation of labor induction increased the spontaneous vaginal delivery A spontaneous vaginal delivery (SVD) occurs when a pregnant woman goes into labor without use of drugs or techniques to induce labor, and delivers her baby in the normal manner, without a cesarean section. rate, reduced oxytocic drug use, shortened induction to delivery interval, and improved patient satisfaction." If your clients cannot avoid a medical induction, they may want to talk to their care provider about the option of membrane sweeping prior to starting an induction, so that they can optimize their chances for a vaginal birth. SOURCE: P.C. Tan, R. Jacob, and S.Z. Omar, Membrane Sweeping at Initiation of Formal Labor Induction: A Randomized Controlled Trial A randomized controlled trial (RCT) is a scientific procedure most commonly used in testing medicines or medical procedures. RCTs are considered the most reliable form of scientific evidence because it eliminates all forms of spurious causality. , Obstetrics & Gynecology 2006;107:569-577. |
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