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Stripping of the membranesFrom: Dr Paul-André Latulippe (Paul-Andre.Latulippe@sympatico.ca)Thu Feb 25 07:50:20 1999
Dear colisters, I saw a few day ago, a post who was talking about the opportunity to strip the membranes for a parturient at 38 weeks. This is the result of a little search about that. ~~~~~~~~~~~~~~~~~~ Référence: Boulvain M, Irion O. Stripping/sweeping of the membranes to induce labour or to prevent post-term pregnancy (Cochrane Review). In: The Cochrane Library, Issue 4, 1998. Oxford: Update Software. Email address of the first author: michel.boulvain@hcuge.ch Cochrane extracts 1) " Sweeping the membranes in women at term generally reduces the delay between randomisation and spontaneous onset of labour, or between randomisation and delivery, by a mean of four days. This intervention also increased the likelihood of either spontaneous labour within 48 hours or of delivery within one week. Sweeping the membranes, performed as a general policy from 38-40 weeks onwards, decreased the frequency of 'post-term' pregnancy defined as pregnancy continuing beyond 42 weeks and beyond 41 weeks. " 2) "A reduction in the frequency of using other methods to induce labour in women allocated to 'sweeping' was reported in most trials. The overall risk reduction in the available trials was 17%. The available evidence suggests that sweeping of the membranes reduces the duration of pregnancy. For women thought to require induction of labour, a reduction in the use of more 'formal' methods of induction could be expected." 3)"No major side effect was reported, but women in the 'sweeping' group reported significant discomfort during the intervention and some 'minor' side effects such as bleeding or irregular contractions. This must be taken into account while discussing management options with women for whom induction of labour is decided. No increase in premature rupture of membranes or in infection. 4)"However, no clear benefits on substantial outcomes (eg Caesarean section) were reported. The intervention was not shown to be associated with substantial benefits on maternal or neonatal outcomes. In summary: If you do it you don't hurt... and if you don't do it, you are not in the false. Dr Paul-André Latulippe MD FRCCP(s) Ob/Gyn 111 Rang 9 St-Christophe d'Arthabaska Québec,Canada G6P 6S1 Paul-Andre.Latulippe@sympatico.ca tel:(819) 357-1784
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