Likewise, do not refuse an intervention just because you do not want an intervention. Do not allow medical professionals to push you into something unnecessary just because it would be more convenient for them to deliver your baby during the week instead of on the weekend. It is also important to remember that your health and the health of your baby should be at the forefront of any decision making. When you understand how the sweep is done, why it is going to happen, what it will do to your body and all of the possible steps to be taken if it is unsuccessful, then you can decide, with your healthcare team, if it is the right thing to do at this stage of your pregnancy. It involves a minimally invasive technique where your midwife or doctor will try to persuade your cervix it is time to loosen up and let that baby out of there.īefore you consent to a membrane sweep, and it does require your informed consent and not just be done as a regular part of an internal exam, it is important to arm yourself with all the information you can. As the due date gets closer, the clocks slow down and every day stretches on for longer and longer.Īnytime between 39 and 43 weeks (sometimes earlier in certain circumstances) mom might be offered a "sweep", a "cervical sweep", a "membrane sweep", or a "stretch and sweep." These are all basically the same thing (the slight difference in the stretch and sweep will be explained) and are used when it is thought things might need a little push for you to get going with your big pushes. Term pregnancy membrane stripping membrane sweeping post-dates pregnancy postmaturity stretch and sweep.Ask any pregnant woman at around 39 weeks or more if she is ready to have the baby and the answer will probably be a resounding yes. This may result in a decreased risk of requiring a formal induction of labour for postmaturity. We recommend therefore that there could be a reduction in the gestation at which membrane sweeping is offered from 40 weeks for primiparous women and 41 weeks for multiparous women to 38 weeks onwards for all low risk women without any increased risk of maternal or foetal morbidity. What the implications are of these findings for clinical practice and/or further research? There is no evidence supporting any increase in maternal or foetal morbidity suggesting that membrane sweeping is a safe procedure to offer to all low risk pregnant women. However, the results of this review suggest that this effect is significant from 38 weeks of gestation, and is not dependent upon the number or timing of membrane sweeps performed. This study clearly demonstrates that membrane sweeping is effective in promoting a spontaneous labour and thereby reducing the need for a formal induction of labour. What the results of this study add? The results from this meta-analysis add to the body of existing evidence around membrane sweeping. For these reasons, it is currently recommended by The National Institute for Health and Care Excellence (NICE 2008 ) that women are offered a membrane sweep to promote spontaneous labour prior to arranging a formal induction of labour. 2014 ), as well as having an impact on NHS resources (Department of Health 2015 ), and the birth experience of women (Gatward et al. However, all of the induction methods carry some degree of risk in terms of the associated morbidities and effectiveness (Cunningham 2005 Simpson and James 2008 Thomas et al. Consequently, a formal induction of labour is usually offered to low-risk pregnant women between 41 and 42 weeks of pregnancy. Impact Statement What is already known on this subject? Research suggests that a pregnancy which exceeds 42 weeks of gestation is associated with an increased risk of perinatal morbidity and mortality (Gulmezoglu et al. The studies reported several varying outcomes for both maternal and foetal morbidities meta-analyses were performed where possible on each of these and found there to be no statistically significant differences in outcome between the intervention and control groups. The results revealed that membrane sweeping is advantageous in promoting spontaneous labour (RR = 1.205, 95% CI: 1.133-1.282, p = <.001), and reducing the formal induction of labour for postmaturity (RR = 0.523, 95% CI: 0.409-0.669, p = <.001). A total of seven studies consisting of 2252 participants were selected for the review and meta-analysis. Relative risk (RR) and its 95% confidence interval (CI) were used as pooled statistics. Based on articles published between 20, 12 electronic databases were searched. The aim of this study was to evaluate the efficacy and the safety of membrane sweeping in promoting spontaneous labour and reducing a formal induction of labour for postmaturity.
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