Publication:

A cross-sectional study for induction to delivery interval with sweeping of membrane followed by misoprostol

Background Post-term pregnancy carries increased maternal and neonatal risks, necessitating timely and effective induction. Membrane sweeping is a simple mechanical technique that promotes endogenous prostaglandin release and may enhance the cervical-ripening effect of misoprostol. This study evaluated whether membrane sweeping before misoprostol improves induction outcomes in term nulliparous women.

Methods A cross-sectional study was conducted among 78 low-risk nulliparous women ≥40 weeks. Group 1 (n=39) received misoprostol alone, and group 2 (n=39) underwent membrane sweeping followed by misoprostol. Primary outcome was the induction-to-delivery interval; secondary outcomes included latency period, induction-to-full dilatation, labor duration, oxytocin requirement, maternal complications, and neonatal outcomes. Standard statistical tests and logistic regression were applied using IBM SPSS v1.0.0.1406.

Results Baseline characteristics were comparable (mean age 26.47 years, BMI 23.38 kg/m2, gestational age 40.32 weeks, Bishop score 4.37). Membrane sweeping significantly shortened duration of labor and time to full dilatation (p<0.05). The mean induction-to-delivery interval was 18.01 hours, with a faster trend in the sweeping group. Latency period strongly correlated with full dilatation (r=0.853) and induction-to-delivery interval (r=0.876) (p<0.001). Maternal and neonatal complications were similar. Mean APGAR scores were 6.87 at 1 minute and 8.88 at 5 minutes; mean birth weight 3.11 kg.

Conclusions Membrane sweeping before misoprostol is a safe and effective adjunct that improves labor progression without increasing maternal or neonatal risks.