A Comparative Study of Amniotic Membrane Stripping and Non-Stripping for Induction of Labor in Low-Risk Term Pregnancies
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Abstract
Background: Amniotic membrane stripping is a simple, low-cost obstetric intervention that may promote spontaneous labor by stimulating endogenous prostaglandin release, but locally relevant evidence from low-risk term pregnancies remains limited. Objective: To compare serial membrane stripping with non-stripping care for spontaneous labor onset, delivery mode, intervention requirements, and maternal and neonatal safety in low-risk term pregnancies. Methods: This quasi-experimental comparative study was conducted at Sheikh Zayed Hospital, Rahim Yar Khan, from January to December 2024. A total of 140 women with uncomplicated singleton cephalic pregnancies at 38-40 weeks were allocated by systematic alternate assignment to membrane stripping (n=70) or non-stripping care (n=70). Stripping was scheduled on Days 1, 3, and 7 when clinically applicable. Outcomes included spontaneous labor within 7 days, time to labor onset, mode of delivery, oxytocin augmentation, formal induction, and complications. Results: Spontaneous labor within 7 days occurred more frequently with stripping than non-stripping care (74.3% vs 45.7%; RD 28.6%, 95% CI 13.0-44.1; p<0.001). Time to labor onset was shorter (3.4 ± 1.8 vs 7.2 ± 2.9 days; p<0.001), spontaneous vaginal delivery was higher (90.0% vs 75.7%; p=0.026), and cesarean delivery was lower (10.0% vs 24.3%; p=0.026). Serious maternal and neonatal outcomes were comparable. Conclusion: Serial membrane stripping improved labor efficiency and reduced intervention use without a significant increase in adverse outcomes.
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