Background: Post-term pregnancy is a high？risk pregnancy. Objectives: This study evaluated the effectiveness and safety of foetal membranes stripping at 40 completed weeks of gestation on the prevalence of late-term pregnancies at the Yaounde Gynaecology-Obstetrics and Paediatrics Hospital (YGOPH). Materials and Methods: Our study is a prospective hospital-based cohort study, conducted over a period of 06 months from February 2023 to July 2023. Three hundred and eighty-eight pregnant women at 40 completed weeks of gestation were enrolled into two groups with: exposed group (those with foetal membranes stripping) and unexposed group (those without foetal membranes stripping). Stripping of foetal membranes was done just once. Participants were followed-up till delivery or attainment of 41 completed weeks of gestation. Results: Post term delivery was significantly lower in the membrane stripping group compared with the unexposed group (12% vs. 43%; P < 0.001). There was a significantly lower mean-time interval from recruitment to spontaneous labour-onset among the membranes stripping group (2.51 ± 0.98 days) compared with the unexposed group (4.33 ± 1.18; P < 0.001). Onset of spontaneous labour in the exposed group was 171 (88%) compared to the unexposed group that had 111 (57%) (P < 0.001). There was no statistically significant difference in the incidence of premature rupture of membranes and perinatal outcomes. Conclusion: Stripping of the foetal membranes appears to be an effective and safe procedure in reducing the incidence of late-term pregnancies and duration of pregnancy at term in low？risk population.
References
[1]
Caughey, A.B., Snegovskikh, V.V. and Norwitz, E.R. (2008) Postterm Pregnancy: How Can We Improve Outcomes? Obstetrical & Gynecological Survey, 63, 715-724. https://doi.org/10.1097/ogx.0b013e318186a9c7
[2]
Dare, F.O. and Oboro, V.O. (2002) The Role of Membrane Stripping in Prevention of Post-Term Pregnancy: A Randomised Clinical Trial in Ile-Lfe, Nigeria. Journal of Obstetrics and Gynaecology, 22, 283-286. https://doi.org/10.1080/01443610220130571
[3]
Mitchell, M.D., Flint, A.P., Bibby, J., Brunt, J., Arnold, J.M., Anderson, A.B., et al. (1977) Rapid Increases in Plasma Prostaglandin Concentrations after Vaginal Examination and Amniotomy. BMJ, 2, 1183-1185. https://doi.org/10.1136/bmj.2.6096.1183
[4]
Keirse, M.J.N.C., Thiery, M., Parewijck, W. and Mitchell, M.D. (1983) Chronic Stimulation of Uterine Prostaglandin Synthesis during Cervical Ripening before the Onset of Labor. Prostaglandins, 25, 671-682. https://doi.org/10.1016/0090-6980(83)90121-1
[5]
Yildirim, G., Güngördük, K., Karadağ, Ö.İ., Aslan, H., Turhan, E. and Ceylan, Y. (2009) Membrane Sweeping to Induce Labor in Low-Risk Patients at Term Pregnancy: A Randomised Controlled Trial. The Journal of Maternal-Fetal & Neonatal Medicine, 23, 681-687. https://doi.org/10.3109/14767050903387078
[6]
Royal College of Obstetricians and Gynaecologists (2008) Induction of Labour. In: Evidence-Based Clinical Guideline Number 9, RCOG Clinical Support Unit, 59-62.
[7]
Berghella, V., Rogers, R. and Lescale, K. (1996) Stripping of Membranes as a Safe Method to Reduce Prolonged Pregnancies. Obstetrics & Gynecology, 87, 927-931. https://doi.org/10.1016/0029-7844(96)00046-4
[8]
Magann, E.F., Chauhan, S.P., Nevils, B.G., McNamara, M.F., Kinsella, M.J. and Morrison, J.C. (1998) Management of Pregnancies Beyond Forty-One Weeks’ Gestation with an Unfavorable Cervix. American Journal of Obstetrics and Gynecology, 178, 1279-1287. https://doi.org/10.1016/s0002-9378(98)70334-5
[9]
Martin, J.A., Hamilton, B.E., Sutton, P.D., Ventura, S.J., Menacker, F., Kirmeyer, S., et al. (2007) Births: Final Data for 2005. National Vital Statistics Reports, 56, 1-103.
[10]
Ventura, S.J., Martin, J.A., Curtin, S.C., Mathews, T.J. and Park, M.M. (2000) Births: Final Data for 1998. National Vital Statistics Reports, 48, 1-100.
[11]
Roberts, C.L., Taylor, L. and Henderson-Smart, D. (1999) Trends in Births at and beyond Term: Evidence of a Change? BJOG: An International Journal of Obstetrics & Gynaecology, 106, 937-942. https://doi.org/10.1111/j.1471-0528.1999.tb08433.x
[12]
Ekele, B.A. and Oyetunji, J.A. (2002) Induction of Labour at Usmanu Danfodiyo University Teaching Hospital, Sokoto. Tropical Journal of Obstetrics and Gynaecology, 19, 74-77.
[13]
Emuveyan, E.E. (2002) Prolonged Pregnancy. In: Kwawukume, E.Y. and Emuveyan, E.E., Eds., Comprehensive Obstetrics in the Tropics, Asente and Hittscher, 135-139.
[14]
Ekele, B.A., Nnadi, D.C., Gana, M.A., Shehu, C.E., Ahmed, Y., Nwobodo, E.I., et al. (2007) Misoprostol Use for Cervical Ripening and Induction of Labour in a Nigerian Teaching Hospital. Niger Journal Clinical Practice, 10, 234-237.
[15]
Goeree, R., Hannah, M. and Hewson, S. (1995) Cost-Effectiveness of Induction of Labour versus Serial Antenatal Monitoring in the Canadian Multicentre Post-Term Pregnancy Trial. CMAJ, 152, 1445-1450.
[16]
Nasim, A., Tahir, R. and Nusrat, U. (2011) Is Membrane Sweeping Appropriate in Modern Obstetrics for Induction of Labour in Post-Date Pregnancies? Pakistan Journal of Surgery, 27, 223-228.
[17]
Cohen, W.R. and Friedman, E.A. (2023) The Latent Phase of Labor. American Journal of Obstetrics and Gynecology, 228, S1017-S1024. https://doi.org/10.1016/j.ajog.2022.04.029
[18]
Magann, E., et al. (2011) Randomized Clinical Trial Evaluating the Frequency of Membrane Sweeping with an Unfavorable Cervix at 39 Weeks. International Journal of Women’s Health, 3, 287-294. https://doi.org/10.2147/ijwh.s23436
[19]
De Miranda, E., Van Der Bom, J., Bonsel, G., Bleker, O. and Rosendaal, F. (2006) Membrane Sweeping and Prevention of Post-Term Pregnancy in Low-Risk Pregnancies: A Randomised Controlled Trial. BJOG: An International Journal of Obstetrics & Gynaecology, 113, 402-408. https://doi.org/10.1111/j.1471-0528.2006.00870.x
[20]
Mozurkewich, E.L., Chilimigras, J.L., Berman, D.R., Perni, U.C., Romero, V.C., King, V.J., et al. (2011) Methods of Induction of Labour: A Systematic Review. BMC Pregnancy and Childbirth, 11, Article No. 84. https://doi.org/10.1186/1471-2393-11-84
[21]
Zamzami, T. and Al Senani, N. (2014) The Efficacy of Membrane Sweeping at Term and Effect on the Duration of Pregnancy: A Randomized Controlled Trial. Journal of Clinical Gynecology and Obstetrics, 3, 30-34. https://doi.org/10.14740/jcgo225w
[22]
Isah, D., Nyamzi, M., Offiong, R. and Isah, A. (2019) Effectiveness of Sweeping of Membranes in Reducing the Incidence of Elective Induction of Labor for Postdate Pregnancies. Archives of Medicine and Surgery, 4, 15-21. https://doi.org/10.4103/archms.archms_36_18
[23]
Averill, K.A., Scardo, J.A. and Chauhan, S.P. (1999) Weekly Membrane Stripping to Decrease the Incidence of Postterm Pregnancy: A Randomized Clinical Trial. Obstetrics & Gynecology, 93, S47. https://doi.org/10.1016/s0029-7844(99)90103-5
[24]
Allott, H.A. and Palmer, C.R. (1993) Sweeping the Membranes: A Valid Procedure in Stimulating the Onset of Labour? BJOG: An International Journal of Obstetrics & Gynaecology, 100, 898-903. https://doi.org/10.1111/j.1471-0528.1993.tb15103.x
