Membrane sweep at 39 weeks success rate full#
Membrane sweep at 39 weeks success rate trial#

Pharmacological methods include the use of prostaglandins, such as dinoprostone administered either vaginally or intracervically misoprostol administered orally, vaginally or intracervical and oxytocin administered intravenously. Labour may be induced using pharmacological, surgical and mechanical methods. The incidence of maternal complications such as severe perineal injury (third- and fourth-degree perineal lacerations) related to macrosomia, post-partum haemorrhage, chorioamnionitis and endomyometritis is increased post-term. Birth post 42 weeks’ gestation carries an increased risk for the neonate including increased risk of meconium aspiration, neonatal acidaemia, low Apgar scores, macrosomia and neonatal death. The rates of post-term pregnancy, defined as a pregnancy that has reached 42 weeks gestation from the last menstrual period (LMP), vary worldwide (0.2% in Belgium, 5.8% in the USA, 7% in Sweden).

Membrane sweep at 39 weeks success rate full#

Ī pregnancy is considered to have reached full term at 37 completed week’s gestation however, some pregnancies will continue past 41 weeks’ completed gestation and are then considered ‘post-term’. Of these, post-term pregnancy is the most common. Medical indications for induction of labour include preterm premature rupture of membranes (PPROM), intrauterine growth restriction, hypertensive disorders of pregnancy, intrauterine foetal death and post-term pregnancies. Conversely, in response to the findings of recent studies which report that elective pharmacological induction of labour results in a lower risk of caesarean section than expectant management, the American College of Obstetricians and Gynecologists has amended their guidance to support elective induction of labour of low-risk women, having their first baby, at 39 weeks gestation. Ĭurrent World Health Organization guidelines note that induction of labour, as with any intervention, carries risks and advise that induction of labour is not recommended for women with uncomplicated pregnancies less than 41 weeks gestation. Approximately one in four pregnancies in the developed world will end with an induction of labour. Induction of labour is the process of artificially stimulating uterine contractions to initiate the onset of labour. However, some women will have an induction of labour. Labour and childbirth are physiological processes, and for the majority of women, the onset of labour is spontaneous.

Membrane sweep at 39 weeks success rate trial#

Results will inform whether and how the design of the definitive trial as originally envisaged should be delivered or adapted. The primary aim of the MILO Study is to inform the optimal design of a future definitive randomised trial to evaluate the effectiveness (including optimal timing and frequency) of membrane sweeping to prevent post-term pregnancy. Focus groups will be held with women and clinicians to explore the acceptability and feasibility of the proposed intervention, study procedures and perceived barriers and enablers to recruitment. Outcomes to be collected include recruitment and retention rates, compliance with protocol, randomisation and allocation processes, attrition rates and cost-effectiveness. (1) a multicentre, pilot randomised trial (2) a health economic analysis (3) a qualitative study and (4) a study within the host trial (a SWAT). The proposed feasibility study consists of four work packages, i.e. Women allocated randomly to a sweep will then be randomised further (factorial component) to early (from 39 weeks) versus late (from 40 weeks) sweep commencement and a single versus weekly sweep. Pregnant women with a live, singleton foetus ≥ 38 weeks gestation cephalic presentation longitudinal lie intact membranes English speaking and ≥ 18 years of age will be randomised in a 2:1 ratio to membrane sweep versus no membrane sweep. Multicentre, pragmatic, parallel-group, pilot randomised controlled trial with an embedded factorial design. We will also assess the acceptability and feasibility of the proposed trial interventions to clinicians and women (through focus group interviews). However, despite its widespread use, there is an absence of evidence on (a) its effectiveness and (b) its optimal timing and frequency. Amniotic membrane sweeping has been recommended as a simple procedure to promote the spontaneous onset of labour. Post-term pregnancy is associated with an increased risk of maternal complications, respiratory distress and trauma to the neonate.