Membrane Stripping

Aka: Membrane Stripping, Cervical Membrane Sweeping

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II. Indications

  1. Cervical Ripening

III. Contraindications

  1. Placenta Previa

IV. Efficacy

  1. Stimulates Prostaglandin release
  2. Useful as adjunct in Labor Induction
    1. Allows for lower overall Oxytocin dose
    2. Foong (2000) Obstet Gynecol 96:539-42 [PubMed]
  3. Sweeping membranes after 38 weeks gestation prevents late term pregnancy and induction
    1. Number Needed to Treat to prevent one induction: 8
    2. Associated with Relative Risk of pregnancy beyond 41 weeks: 0.59
    3. Associated with Relative Risk of pregnancy beyond 42 weeks: 0.28

V. Adverse effects

  1. Unintentional Rupture of Membranes
  2. Bleeding
  3. Infection
    1. Membrane Stripping appears safe even in mothers with positive GBS Culture
    2. Kabiri (2015) PLos One 10(12):e0145905 [PubMed]

VI. Technique

  1. Confirm no Placenta Previa on Ultrasound prior to performing Membrane Stripping
  2. Use sterile exam gloves
  3. Examining finger inserted into Cervix
  4. Finger moved in circular fashion inside endocervix
  5. Press against internal cervical os
  6. Separates membranes from lower uterine segment

VII. References

  1. Boulvain (2005) Cochrane Database Syst Rev (1): CD000451 [PubMed]
  2. Boulvain (1998) Br J Obstet Gynaecol 105:34-40 [PubMed]
  3. Wheeler (2022) Am Fam Physician 105(2): 177-86 [PubMed]

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