From the Research
A membrane sweep can help with cervical dilation during late pregnancy, as it has been shown to induce labor in 86.4% of postdate women, with a low rate of maternal and fetal complications, as reported in the most recent study 1. This procedure, performed by a healthcare provider during a vaginal examination, involves inserting a finger through the cervical opening and gently separating the amniotic sac from the lower part of the uterus. Membrane sweeping stimulates the release of prostaglandins, which are hormone-like substances that soften and prepare the cervix for labor. The effectiveness of membrane sweeping varies among individuals, with some women experiencing increased cervical dilation while others may not respond as strongly. According to a recent review 2, membrane sweeping may be effective in achieving a spontaneous onset of labor, but the evidence for this was of low certainty. However, when compared to expectant management, it potentially reduces the incidence of formal induction of labor. It is essential to note that membrane sweeping is typically offered after 38-39 weeks of pregnancy and may be repeated if labor doesn't begin. While generally safe, it can cause discomfort, spotting, and irregular contractions. Women should be aware that membrane sweeping doesn't guarantee labor will start immediately, and medical induction may still be necessary if pregnancy continues beyond the recommended timeframe. Some studies have reported that membrane sweeping can increase the spontaneous vaginal delivery rate, reduce oxytocic drug use, shorten induction to delivery interval, and improve patient satisfaction 3. However, the evidence is not conclusive, and more research is needed to determine the optimal number of membrane sweeps and timings to facilitate induction of labor. In clinical practice, the decision to perform a membrane sweep should be based on individual patient circumstances and medical history, taking into account the potential benefits and risks, as well as the patient's preferences and values. Key points to consider include:
- Membrane sweeping can induce labor in a significant proportion of postdate women
- The procedure is generally safe, but may cause discomfort and other adverse effects
- The evidence for the effectiveness of membrane sweeping is of low certainty
- Membrane sweeping may reduce the incidence of formal induction of labor
- Individual patient circumstances and medical history should guide the decision to perform a membrane sweep.