Medical News Today: What to know about membrane stripping

Membrane stripping, also known as membrane sweeping, is a procedure that can help induce labor in pregnant women who are close to or past their due date. A doctor will use a gloved hand to sweep the inside of the cervix in a circular motion. Membrane stripping is effective and safe for most women.

In uncomplicated pregnancies, membrane stripping at 38–40 weeks of gestation will often:

  • increase the rate of spontaneous vaginal labor
  • reduce the need for other induction methods, such as medication
  • decrease the likelihood of the pregnancy lasting beyond 41 weeks

The procedure aims to separate the amniotic sac and fine fetal membranes from the uterine wall. This separation triggers the release of natural chemicals called prostaglandins. Prostaglandins help soften the cervix and stimulate contractions and labor.

What to expect before and after

Doctor putting on gloves before membrane stripping
Doctors perform membrane stripping as part of a regular examination.

Women do not generally need to prepare for membrane stripping, which the doctor will carry out as part of a regular examination.

The procedure usually takes place in a doctor’s office. The doctor may need to stimulate the cervix to dilate it, as membrane stripping will not be possible otherwise.

The procedure can be uncomfortable, and most women feel a bit of pain and tenderness afterward. Some women also experience minor bleeding.

It is essential to let the doctor know immediately if severe pain or bleeding occurs during or after the appointment.


Risks and safety

Membrane stripping is usually safe in uncomplicated pregnancies.

However, there are minor risks associated with this technique. These include:

  • mild discomfort during the procedure
  • minor vaginal bleeding
  • irregular contractions

Membrane stripping carries minimal risk, but it still may not be suitable for everyone.

Who should not have membrane stripping?

A doctor is likely to decide against membrane stripping in women who are showing signs of needing a cesarean delivery. The following factors might also make the procedure unsuitable:

  • prior cesarean delivery
  • multiple births
  • history of preterm delivery
  • current bacterial cervical infection
  • placenta previa, where the placenta covers the opening of the cervix
  • active herpes infection
  • vasa previa, a condition in which membranes containing blood vessels that connect the fetus and the placenta cover the opening of the cervix
  • severe fetal abnormalities
  • Mullerian duct abnormalities
  • abnormal fetal position
  • structural pelvic abnormalities
  • prior uterine rupture

Is it effective?

changing position
Studies suggest that membrane stripping can help induce labor.

In most cases, membrane stripping increases the likelihood of spontaneous labor, especially within the first 7 days following the procedure.

Doctors usually only need to carry out the procedure once to induce labor successfully. However, some women may require multiple stripping procedures.

A 2014 study looking at the efficacy and safety of membrane stripping found that it reduced total gestation time.

The study, which included 80 women who had the procedure and 80 who did not, showed that:

  • Of the women who received membrane stripping, 90 percent went into spontaneous labor compared to 75 percent of those who did not have the procedure.
  • Only 10 percent of the women who received membrane stripping were still pregnant at 41 weeks of gestation compared to 25 percent of those who did not.
  • Membrane stripping did not affect the risk of maternal or fetal complications.

Another study of 800 women found that membrane stripping:

  • reduced the time between induction and labor
  • increased the vaginal delivery rate
  • lowered the need for oxytocin, a drug that induces labor

However, the researchers also used other methods of induction alongside the membrane stripping.


Takeaway

Membrane stripping takes place during the final few weeks of pregnancy, which are usually between 38 and 41 weeks of gestation.

Membrane stripping is a relatively safe procedure in uncomplicated pregnancies, and study results have shown that it can increase the likelihood of spontaneous labor.

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