BJOG: an international journal of obstetrics and gynaecology. Membrane sweeping and prevention of post-term pregnancy in low-risk pregnancies: a randomised controlled trial. Midwifery and quality care: findings from a new evidence-informed framework for maternal and newborn care. Renfrew MJ, McFadden A, Bastos MH, Campbell J, Channon AA, Cheung NF, et al. American journal of obstetrics and gynecology. Parturitional factors associated with membrane stripping. McColgin SW, Bennett WA, Roach H, Cowan BD, Martin JN Jr., Morrison JC. This action helps release prostaglandins, the hormone-like substances that may promote labor. The development of methods for inducing labour Effective Care in Pregnancy and Childbirth.: Chalmers I, Enkin M, Keirse MJ, editors. Membrane Sweeping/Stripping Membrane stripping is done by your doctor inserting a finger into the cervical opening during a sterile vaginal examination and sweeping in a circular motion. Induction of labor by stripping membranes. GBS-Negative groups 0.67 (95%, CI = 0.30-1.50)) while composite adverse maternal outcomes occurred in 9 (6.66%), 31 (8.59%), and 5 (10.87%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.617).Īntepartum membrane stripping in GBS carriers appears to be a safe obstetrical procedure that does not adversely affect maternal or neonatal outcomes. Adverse neonatal outcomes were observed in 8 (5.9%), 31 (8.6%), and 2 (4.3%) in the GBS-positive, GBS-negative, and unknown groups, respectively (P = 0.530), (Odds Ratio between GBS-Positive vs. Your medical provider will insert their finger into your cervix and separate (sweep/strip) the amniotic sac from your uterine wall. It is typically performed in the office of your care provider. Demographic, obstetric, and intra-partum characteristics were similar for all groups. Stripping or sweeping of membranes is an option that can be done in an effort to get labor going without introducing any medication into the body. We compared the incidence of composite adverse neonatal outcomes (primary outcome) among the three study groups, while secondary outcome measure was composite adverse maternal outcomes.Ī total of 542 women were included in the study, of which 135 were GBS-positive, 361 GBS-negative, and 46 GBS-unknown status. We conducted a prospective study in a tertiary referral center, comparing maternal and neonatal outcomes following membrane stripping among GBS-positive, GBS-negative, and GBS-unknown patients. If the cervix will not admit a finger, massaging around the cervix in the vaginal fornices may achieve a similar effect. We conducted 'the STRIP-G study' in order to determine whether maternal and neonatal outcomes are affected by GBS carrier status in women undergoing membrane stripping. Membrane sweeping involves the examining finger passing through the cervix to rotate against the wall of the uterus, to separate the chorionic membrane from the decidua of the uterus.
Separating the amniotic membranes from the uterus shortens the labor. It is only possible if your cervix has begun to dilate, not if it is still closed. Due to the theoretical concern of bacterial seeding during the procedure many practitioners choose not to sweep the membranes in Group B Streptococcus (GBS) colonized patients. A membrane sweep is a procedure during which your GP/midwife runs a gloved finger across the membranes that connect the amniotic sac (a fluid-filled sac containing your baby) to the uterus. Their hospital stay may be longer than with a spontaneous labour.Stripping of the membranes is an established and widely utilized obstetric procedure associated with higher spontaneous vaginal delivery rates, reduced need for formal induction of labor and a lower likelihood of post-term pregnancy. Pharmacological methods of induction can cause hyperstimulation – this is when the uterus contracts too frequently or contractions last too long, which can lead to changes in fetal heart rate and result in fetal compromiseĪn induced labour may be more painful than a spontaneous labour There may be a need for an assisted vaginal birth (using forceps or ventouse), with the associated increased risk of obstetric anal sphincter injury (for example, third- or fourth-degree perineal tears) There may be limitations on the use of a birthing pool Their choice of place of birth will be limited, as they may be recommended interventions (for example, oxytocin infusion, continuous fetal heart rate monitoring and epidurals) that are not available for home birth or in midwife-led birth units Vaginal examinations to assess the cervix are needed before and during induction, to determine the best method of induction and to monitor progress
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