Effectiveness of Membrane Sweeping on Successful Initiation of Labor and Subsequent Vaginal Birth in Patients with Previous One Cesarean Section

Abstract

Objective: To assess the impact of membrane sweeping on labour initiation, the success of vaginal delivery and neonatal outcomes in patients who have had a prior caesarean section.

Methodology: This randomized controlled trial study registration no NCT06103071 was conducted at HIT Hospital, Taxila, in collaboration with POF Hospital, Wah Cantt, from 15th Jan 2023 to 15th July 2024. Three hundred and eight four pregnant females with previous cesarean section for non-recurrent cause were enrolled. Two groups were made. In Group A, membrane sweeping was done. In Group B, no membrane sweeping was done. The primary outcome measures the onset of labour. Secondary outcome measures of successful vaginal delivery and fetal outcome, i.e. admission to NICU, were recorded.

Results: Females in membrane sweeping had a mean age of 29.24 ± 7.99 years, while in the control group, the mean age of females was 30.54 ± 6.72 years. The onset of labour occurred in 119 (62%) cases with membrane sweeping versus 90 (46.9%) cases in the control group (p-value 0.003). In the membrane-sweeping group, 71 (37.0%) had normal vaginal delivery. In the control group, 60 (31.3%) had a normal vaginal delivery. There was no significant difference in NICU admission in both groups. In the control group, NICU admission was [22 (11.5%)], and in the membrane sweeping group was [20 (10.4%), p-value = 0.744].

Conclusion: Thus, membrane sweeping is found to be an effective and safe method to improve the spontaneous onset of labour in patients with previous cesarean section.