The function of the cervix is to provide mechanical strength to retain the growing fetus until term. This makes it more susceptible to colonization and infection by bacteria that normally reside in the vagina and rectum during pregnancy and in labor. The pregnant uterus is anatomically connected to the vagina through the cervix. The mucosa of the vagina is continuous with the skin of the thigh, perineum and has an anatomical proximity to the anal canalĪnd the rectum. What are the Potential Risks of the “Membrane Sweeping”? A Bishop’s score to assess the cervical length, dilatation, effacement, consistency position of cervix and fetal descent is used to predict the prognosis of the membrane sweep and the induction process. Mc Colgin confirmed that the membrane sweep was associated with an increased activity of prostaglandin F2 and phospholipase A. Membrane sweeping was first suggested by James Hamilton in 1810 for labor induction. Membrane stripping or sweeping involves a vaginal examination during which a finger is introduced into the cervical os to separate the membranes from the lower uterine segment by a circular movement. History and Practice of “Membrane sweeping” (Artificial Separation of Membranes or “ASOM”) Keywords: Artificial separation of membranes Membrane sweep Ascending infection Zig Zag Pattern Prostaglandins ColonizationĪbbreviations: CTG: Cardiotocograph NHS: National Health Service ASOM: Artificial Separation of Membranes GBS: Group -B, Streptococcus Midwives and obstetricians owe their patients a duty of care to weigh the reported benefits of the ASOM against the potential risks of fetal infection, whilst recommending this historical practice which was introduced prior to the advent of chemical (e.g., prostaglandins), or mechanical (e.g., cervical balloon catheters) methods, in contemporary obstetric practice. We have analyzed the current systematic evidence on the “Membrane Sweep” to determine its efficacy. On the other hand, there are potential risks of introducing bacteria from the maternal vagina into the chorio-decidual space, increasing the risks of inflammation and infection. questioned the efficacy of the “Membrane Sweep”, as the likelihood of a spontaneous labor was found to be very modest and with no reduction in operative deliveries or an increase in spontaneous vaginal births following ASOM. In the absence of other chemical and mechanical methods to ensure cervical ripening, the “Membrane Sweep” became established in obstetric practice for approximately 200 years. The “membrane sweep” or artificial separation of membranes (ASOM) was introduced into clinical practice to artificially initiate labor, and to avoid the risks of a prolonged pregnancy. The Historical Practice of “Membrane Sweep” to Initiate Labour: Does it Have a Role in Contemporary How to cite this article: Suganya S, Edwin C. *Corresponding author: Edwin Chandraharan, Director, Global Academy of Medical Education & Training, London &, Consultant Intrapartum Care Advisor, Basildon University Hospital, Mid and South Essex NHS Foundation Trust, Essex, UK To Initiate Labour: Does it Have a Role in Contemporary Obstetric Practice? Suganya Sukumaran 1 and Edwin Chandraharan 2*ġObstetrics & Gynaecology, South Warwickshire NHS Foundation Trust, UKĢGlobal Academy of Medical Education & Training, Basildon University Hospital, UK Research Article The Historical Practice of “Membrane Sweep” Scientific Evidence Regarding the Effectiveness of “Membrane Sweeping”.What are the Potential Risks of the “Membrane Sweeping”?.History and Practice of “Membrane sweeping” (Artificial Separation of Membranes or “ASOM”).
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