Membrane Sweeping andโ its โฃImpact on Labor and Delivery: A Systematic Review Analysis
A recent systematic review and โคmeta-analysis, published in BMC Pregnancy and โขChildbirth, investigated the effectiveness of membrane sweeping in term pregnancy for promoting spontaneous labor and preventingโ post-term โpregnancy.โ The analysis synthesized data from numerous studies to evaluate the procedure’s impact on various maternal and neonatal outcomes.
The review encompassedโข twenty-seven studies evaluating vaginal delivery rates.Results demonstrated a statistically significant improvement with membrane sweeping (RR = 1.07, 95% CI: [1.03,1.11], P* = 0.0008).โค Correspondingly, theโข analysis of these same twenty-seven studies revealed a lower rate of cesarean section in the membrane sweeping group comparedโ toโค routine care (RR = โ0.81, 95% CI: [0.70, 0.95], *P = 0.008). However, no significant difference was โขobserved in โคthe incidence of โinstrumental delivery between the two groups (RR = 1.04,95% CI: [0.89, 1.22], P* = 0.63).
further analysisโ of seven studiesโ focused onโข the time interval between membrane sweeping andโข delivery. The pooled results indicated a significant shortening of this โฃinterval following the procedure (MD = -4.51,โข 95% CI: โ [-6.86,-2.16], *P = 0.0002).
regarding maternal safety, the โขreview of nineteen studies involving 3954 โฃwomen found no โsignificantโค difference in the incidence of pre-labor โขrupture of โคmembranes between those undergoing membrane sweeping and those receivingโค routine care. Similarly, noโ statistically significant differences were identified in the rates โขof intrapartum orโฃ postpartum fever. An analysis โof eight studies also showed no significant difference in the incidence of meconium-stained liquor.
The analysis also examined neonatal outcomes. the proportion โof one-minute/five-minute apgarโ scores less than 7 was substantially lower in the membrane sweeping group. Thirteen studies โevaluating neonatal intensive Care Unit (NICU) admission rates showed โa โคlower rate of admission in the membrane โฃsweeping group (RR = 0.70, 95% CI: [0.51,0.95], *P* = 0.02).โข Though, โsix studies assessing neonatal infection rates found no statistically significant difference between the groups.
The researchers assessed potential publication bias usingโค funnelโค plots andโ Egger’s test, with resultsโ detailed in Supplementary Table 4. โข The quality ofโ evidence for โeach outcome was assessed using the GRADE approach by two autonomous reviewers, categorized as ‘high’, ‘moderate’, ‘low’, or ‘very low’ based on consensus, andโฃ summarized in Supplementary Table 5.