Membrane Sweeps

melaniedel

Anyone have this done? Does it hurt? Did it work? My OB offered it if I'm more dilated next week, and just beginning to research it. Thanks!

mnj05

I've had it done twice. It is definitely not comfortable at all but it didn't hurt me, it felt like some procedures I went through during IVF so it didn't bother me much and I don't have a high pain tolerance.

I lost tons of mucus after both, never spotted. I was dilated to a 3 the first time and a 4 the second time, 80% effaced both times. It didn't work for me and I'm being induced Friday morning anyway.

PepperBug

I had it done several times during my induction with my son.  I can't comment on whether it worked, but I will say that I found it to be extremely painful.  I wouldn't have it done again, but I'm sure other people have had success and less pain.

edilo

I had it done at 38, 39, and 40 weeks with DD. it didn't hurt at all (slightly uncomfortable), at 38 weeks. It hurt quite a bit at 39 and 40 weeks. Lost a lot of mucous after each time and had irregular contractions throughout the day/evening after each time. Nothing came of the first two, but I wanted to avoid induction, so asked for it again at 40 weeks. Was much more uncomfortable/crampy after the 40 week appointment, and my water ended up breaking on it's own the next morning. Contractions/labor started immediately after water broke (unlike with my first).

lightgetsin

I had it done once last time.  It hurt and did not work.  I cramped for a day but that was it. DS was born a week later.

Monsieur_et_Madame_Ha

I have never had it done, but I know a few people who have. Their comments on it went from "Uncomfortable to OMFG did that ever hurt". It worked for most of them, but not always on the first try. 

WinterBenson

My ob tried to do it yesterday, but she said I wasn't dilated enough. It was painful enough and she didn't even get it done!

SunnyMuffin

I would do it, I think the Midwife organization here reccommends that it be offered starting at 39 weeks because it reduces the duration of the pregnancy and reduces the need for inductions.  Mine could never do it last time b/c my cervix was too closed

haleysmama10

I had it done twice with my first. My dr and obgyn kept telling me for weeks how unfavorable my cervix was...meaning long and closed and at 39 weeks my daughter still hadn't dropped. My dr did a membrane sweep at 39 weeks and 1 day and I got mild contractions for a few hours and lost my mucous plug. She did it again at 39 weeks 6 days at which point my cervix was still unfavorable....long and closed with not much change. She stretched my cervix from 1 cm to 2 cm dilated. An hour after I started leaking amniotic fluid and an hour after that my water broke. After my water broke I was getting mild contractions and about 4 hours after my water breaking my labor got going at which point it was very painful. Total time from my initial leaking of amniotic fluid to the birth of our daughter was 11 hours, although only active labor for 6 hours or so.

To answer your questions yes it worked and it was extremely uncomfortable, it did hur but not as much as labor.  It worked for me the 2nd time but I know women who had it done 3, 4, even 5 times without it doing a darn thing. 

Sea Conquest

I am always shocked that so many women consent to having their membranes swept -- most especially when they are before 40w. It has been shown that sweeping of the membranes does not affect that duration of pregnancy, but does increase the risk of PROM (which can lead to malpositioned babies and longer labors) and induction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2582414/ 

RANDOMIZED CONTROLLED TRIAL SHOWS MEMBRANE SWEEPING INCREASES RISK OF WATER BREAKING BEFORE LABOR

• Hill, M. J., McWilliams, G. D., Garcia-Sur, D., Chen, B., Munroe, M., & Hoeldtke, N. J. (2008). The effect of membrane sweeping on prelabor rupture of membranes: A randomized controlled trial. Obstetrics and Gynecology, 111(6), 1313?1319.

Summary

This randomized, controlled trial was designed to determine whether routine membrane sweeping at the end of pregnancy reduces the likelihood of women reaching 41 weeks, and whether the procedure has any adverse effects, specifically membrane rupture before labor. Participants were assigned to have their membranes swept weekly from 38 weeks (n = 162 women) or to have weekly vaginal exams with no membrane sweeping (n = 138 women). The trial was conducted in a U.S. Army medical center in Hawaii and included healthy women with uncomplicated pregnancies, singleton head-down babies, and reliable dating information (e.g., first trimester ultrasound). Both the providers who cared for the women in labor and the laboring women themselves were blinded to whether membrane sweeping had occurred. This was intended to minimize bias, although many participating women may have been aware of their group assignment, because membrane sweeping can be uncomfortable. The study protocol required that women in both groups who reached 41 weeks of gestation be induced for ?impending postmaturity.? Because of problems scheduling these inductions, about 8% of women in each group gave birth at or beyond 42 weeks.

Researchers found no association between assignment to routine weekly membrane sweeping and duration of pregnancy. The proportion of women in both groups who remained pregnant was nearly identical on every succeeding day of gestation. Likewise, mode of birth and maternal or newborn infection rates did not differ between the two groups. Women in the membrane-sweeping group were more likely to experience prelabor rupture of the membranes (PROM), although the difference was not statistically significant, meaning it could have occurred by chance (7% no-sweeping group vs. 12% sweeping group; p = 0.19). However, subgroup analysis revealed a significant effect. Fifteen percent of women assigned to have membrane sweeping were not dilated enough for the clinician to perform membrane sweeping. None of these women had PROM in the week following the cervical massage. When the researchers analyzed the women who were more than 1cm dilated (effectively excluding women who were not eligible for membrane sweeping), 9% of women in the membrane-sweeping group versus 0% of women in the no-sweep group experienced PROM, a difference that achieved statistical significance.

Significance for Normal Birth

Membrane sweeping is often offered to women as a routine measure or to prevent a pharmacologic induction for which a need may eventually arise (for instance, post-term or gestational hypertension). Membrane sweeping is believed to be effective because it results in the release of prostaglandins, which are hormone-like factors involved with initiating labor. A Cochrane systematic review showed that membrane sweeping seemed to hasten the onset of labor but conferred no clinically important benefits (e.g., mode of birth and maternal and newborn health were unaffected). Moreover, membrane sweeping resulted in an increase in the likelihood of pain, bleeding, and irregular contractions (Boulvain, Stan, & Irion, 2005). The Cochrane reviewers did not find an association with PROM. However, several of the included trials were of poor quality, and none of the trials was designed specifically to measure the effect of routine membrane sweeping on PROM.

This randomized, double-blind trial specifically examined the effect of membrane sweeping on PROM and indicated a significant association between routine, weekly membrane sweeping at the end of pregnancy and prelabor rupture of the membranes. Findings suggested that an increase in PROM will result in an increase in induction, the very intervention membrane sweeping is intended to avoid. Indeed, the researchers reported an increase in the membrane-sweeping group (25% vs. 32%), although the difference did not achieve statistical significance, probably because the study was too small. This problem is likely to be magnified by a recent change in the standard of care: In 2007, without citing any new research, the American College of Obstetricians and Gynecologists (ACOG) reversed its former position and declared that women presenting with PROM at term should be induced immediately (ACOG Committee on Practice Bulletins ? Obstetrics, 2007).

This randomized, double-blind trial specifically examined the effect of membrane sweeping on PROM and indicated a significant association between routine, weekly membrane sweeping at the end of pregnancy and prelabor rupture of the membranes.