A majority of women felt that the procedure was “somewhat” painful and 17% found it to be “painful” or “very painful.” Nearly 90% of women would choose membrane sweeping in their next pregnancy. Adverse effects were similarly frequent in the 2 groups except for more frequent bleeding in those assigned to membrane sweeping. Women having membrane sweeping were less likely to receive prostaglandins to induce labor. In parous women, sweeping made it significantly more likely that delivery would take place in a primary care setting. Both nulliparous and parous women benefitted from the procedure. Sweeping reduced the interval between randomization and delivery by 1 day on average, and it significantly increased the chance of spontaneous labor starting before 42 weeks gestation. In the group having membrane sweeping, 27% of women with a Bishop score less than 6 at baseline and 9% of those with an index of 6 or higher had postterm pregnancies. Results were unchanged when only women dated by a first-trimester ultrasound study were analyzed. Sweeping significantly lowered the proportion of postterm pregnancies from 41% to 23%. Of 742 women admitted to the trial, 375 were allocated to membrane sweeping and 367 to a control group. Sweeping was repeated every 48 hours a maximum of 3 times until labor began or gestational age reached 42 weeks. When the cervix was closed, precluding sweeping, it was massaged. The lower membranes were separated to the extent possible from their cervical attachment sites using 3 passes of the examining fingers. All participants had a single fetus in cephalic presentation and lacked pregnancy complications and risk factors. This randomized trial evaluated membrane sweeping starting at 41 weeks gestation in 51 midwifery practices in The Netherlands. However, trials of membrane sweeping have yielded inconsistent results. Both of these effects help to ripen the cervix. “Sweeping” the membranes-separating them digitally from the lower urine segment-is a simple means of promoting spontaneous labor presumably by increasing prostaglandin levels in the maternal circulation as well as local prostaglandin production. Postterm pregnancy, defined as a gestational age of 42 weeks or longer, has been associated with increased perinatal morbidity and mortality. Fifty-five per cent of low birthweight babies in Kaiser were preterm and this fraction did not vary substantially by ethnic group. ![]() ![]() Although Whites and Mexican-Americans had similar birthweight distributions, Mexican-Americans had an increased risk for preterm delivery. Exclusion of cases of premature rupture of membranes, placenta previa, and abruptio placenta did not explain the large ethnic differences. The corresponding odds ratios for very preterm delivery were 2.35 (1.72-3.22) for Blacks, 1.31 (0.88-1.94) for Mexican-Americans, 1.10 (0.67-1.83) for Asians, and 1.00 for Whites. Adjustment for maternal age, education, marital status, employment, parity, number of previous spontaneous or induced abortions, smoking and drinking during pregnancy, infant sex, and gestational age at initiation of prenatal care resulted in the following odds ratios for preterm delivery: 1.79 (1.55-2.08) for Blacks, 1.40 (1.19-1.63) for Mexican-Americans, 1.40 (1.16-1.69) for Asians, and 1.00 for Whites. Blacks had the highest rate of preterm and very preterm delivery, followed by Mexican-Americans, Asians, and Whites. Pregnant women are asked to give their consent before they have a membrane sweep.Ethnic differences in preterm (less than 37 weeks) and very preterm (less than 33 weeks) delivery were evaluated in a prospective cohort of 28,330 women. Pregnant women discuss the option of a vaginal examination to carry out a membrane sweep, in which a healthcare professional moves a finger around the cervix or massages the cervix, to help start labour, at their antenatal appointments after 39 weeks of pregnancy. ![]() ![]() Healthcare professionals discuss the option of vaginal examination for membrane sweeping with pregnant women at their antenatal appointments after 39 weeks of pregnancy and obtain their consent before carrying out membrane sweeping.Ĭommissioners ensure they commission services that discuss the option of vaginal examination for membrane sweeping with pregnant women at their antenatal appointments after 39 weeks of pregnancy and obtain their consent before carrying out membrane sweeping. Service providers ensure that systems are in place to obtain the woman's consent before carrying out membrane sweeping. Service providers ensure that processes are in place to discuss the option of vaginal examination for membrane sweeping with pregnant women at antenatal appointments after 39 weeks of pregnancy. What the quality statement means for different audiences
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