{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:51Z","timestamp":1787022171977,"version":"build-2736575974"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T00:00:00Z","timestamp":1747699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec006\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Any intervention aimed at maximizing the spontaneous onset of labor and preventing formal induction will be beneficial to the client and welcomed by the provider, because it reduces postmaturity and formal labour induction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec007\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited and randomized 312 uncomplicated singleton pregnancies at 38 weeks of gestation into three groups: membrane sweep (MS), cervical massage (CM), and sham sweep (control). Each intervention was administered at 39 weeks and repeated at 40 weeks of gestation if spontaneous labor, defined as a Modified Bishop\u2019s Score of \u22657, did not occur. (Sri Lanka clinical trials registry - SLCTR\/2020\/003).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec008\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The membrane sweep reduced the need for formal induction, whereas cervical massage did not. (MS vs C RR\u2009=\u20091.4195, 95% CI\u2009=\u20091.0326\u20131.9513, p\u2009=\u20090.0310; MS vs C OR=1.8739, 95% CI\u2009=\u20091.0664\u20133.2927, p\u2009=\u20090.0290; Number Needed to Treat\u2009=\u20097; CM vs C RR\u2009=\u20091.2043, 95% CI\u2009=\u20090.8598\u20131.6867, p\u2009=\u20090.2795). \u201cSurvival without spontaneous labor,\u201d was lower after the membrane sweep than in controls overall (MS vs C \u2013 p\u2009=\u20090.007; CM vs C \u2013 p\u2009=\u20090.261), among primiparous (MS vs C p\u2009=\u20090.047; CM vs C p\u2009=\u20090.269) and multiparous (MS vs C p\u2009=\u20090.038; CM vs C p\u2009=\u20090.456) women. The membrane sweep and cervical massage were safe concerning feto-maternal complications and both reduced hospital-stay duration among multiparous women (MS vs C p\u2009&lt;\u20090.0001, 95% CI\u2009=\u20090.5293\u20131.1791; CM vs C p\u2009&lt;\u20090.0001, 95% CI\u2009=\u20090.6816\u20131.3552). There was no increased risk of emergency cesarean delivery, oxytocin augmentation, uterine hyperstimulation, postpartum bleeding, maternal pyrexia, or Apgar score\u2009&lt;\u20097 at 5 minutes (p\u2009&gt;\u20090.05). The membrane sweep was less acceptable compared to cervical massage, regardless of parity (MS vs C Primi p\u2009=\u20090.001, Multi p\u2009=\u20090.0216).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec009\">\n                    <jats:title>Conclusion and recommendations<\/jats:title>\n                    <jats:p>We recommend routine offer of membrane sweep to reduce the need for formal induction in term uncomplicated pregnancies, but clinicians should be aware of its inherent discomfort to women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0324172","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T13:36:02Z","timestamp":1747748162000},"page":"e0324172","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparing membrane sweep and cervical massage in preventing the need for formal labour induction in uncomplicated pregnancy at term: Secondary analysis of a randomized controlled trial"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5876-5567","authenticated-orcid":true,"given":"Thennakoon Mudiyanselage Salila Sameera Bandara","family":"Madugalle","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dissanayaka Mudiyanselage Chandana Sirimewan","family":"Jayasundara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6568-8035","authenticated-orcid":true,"given":"Indu Asanka","family":"Jayawardane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"key":"pone.0324172.ref001","volume-title":"Births: final data for 2009","author":"J 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