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Information to know about GBS and fetal membrane stripping (or sweeping) FMS

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Transcript

Membrane Stripping (or 'Sweeping')

What is it?

How does it work?

Is it safe and effective?

GBS and microorganisms

Concerns of bleeding

Flow chart explanation

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Membrane Stripping (also known as membrane sweeping) is a “traditional” method used to help induce labor going past term (42 weeks). It is a procedure in which the practitioner forces their index finger through the cervix using a circular sweeping motion to forcibly separate the bag of waters from the uterine lining.

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Membrane stripping is theoretically thought to work by causing necrosis (physical and inflammatory cell damage) with subsequent release of prostaglandins to stimulate the uterus to go into labor.

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Is it safe? Although studies have not associated membrane stripping with poor outcomes for babies, current evidence is limited. Be aware that the safety of membrane stripping has not been proven in control studies and that GBS can cross intact membranes. Is it effective? According to the 2020 Cochrane Analysis, the certainty that membrane sweeping is effective in achieving a spontaneous onset of labor is low.

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“Bacterial seeding” is a concern as membrane sweeping could push GBS and other microorganisms such as E. Coli closer to the baby and cross or weaken intact membranes causing stillbirth or babies to be sick at birth.

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Bleeding is a common result of membrane stripping. Cervical blood may “feed” microorganisms and increase infection. Blood is routinely added to culture media used to promote bacterial growth in the lab.

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Illustration credit: Jonathan Dimes @jdimes_medivisual