Abstract
Objective: To study the outcomes of membrane sweep done during induction of labor with sublingual misoprostol at term pregnancy such as the mode of delivery and the induction delivery interval.
Methods: This prospective descriptive study was conducted on 305 term women (237 primigravidas and 68 multigravidas) who received sublingual misoprostol followed by membrane sweep (single or double sweep based on the progress of labor). Main outcome measures included mode of delivery, induction to delivery interval, duration of labor, neonatal outcomes and maternal complications.
Results: Among 237 primigravidas, 108 (45.5%) women delivered after a single sweep and 129 (54.4%) women needed a second sweep. Among 68 multigravidas, 47 (69.1%) delivered after a single sweep and only 21 (30.8%) required a second sweep. The maximum number (75.5%) of primigravidas had a pre-induction Bishop score of 2, while the maximum number (67.6%) of multigravidas had a pre-induction Bishop score of 3. Vaginal deliveries (including instrumental delivery) were more in both primigravidas (55.6%) and multigravidas (88.2%), who received membrane sweep in conjunction with induction of labor. The mean time from the first dose of sublingual misoprostol to the onset of contraction was 6.9 hours in primigravidas and 4.2 hours in multigravidas, while the meantime from the onset of contractions till vaginal delivery (duration of labor) was 11.2 hours in primigravidas and 5.8 hours in multigravidas. The mean interval from induction to the vaginal delivery was 18.8 hours in primigravidas and 14.4 hours in multigravidas.
Conclusion: Sublingual misoprostol, along with membrane sweep at the initiation of labor induction, is an effective intervention despite its association with an increased rate of cesarian section among primigravidas as compared to the literature.
Keywords: Membrane sweep, primigravida, multigravida, sublingual misoprostol, induction of labor, delivery.
Graphical Abstract
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