Does membrane sweep work? Assessing obstetric outcomes and patient perception of cervical membrane sweeping at term in an Irish obstetric population: a prospective multi-centre cohort study

Background Cervical membrane sweep is a mechanical method of cervical ripening at term gestation with the aim of avoiding prolonged pregnancy and reducing the need for labour induction for this indication. There is no published data on obstetric outcomes following membrane sweep in an Irish obstetric population or any studies on patient perception/recommendation of membrane sweep in the international literature. Aims This study is aimed at determining if cervical membrane sweep at term has an effect on duration of pregnancy and delivery outcome in an Irish population. Postnatally, patient perception of the experience of membrane sweep was evaluated as well as their recommendation of the procedure for other women. Methods A prospective multi-centre cohort study of women who had cervical membrane sweep at term was carried out which assesses labour and delivery outcomes as well as patient perceptions in women undergoing membrane sweep. Results Spontaneous labour occurred in 79% of women following membrane sweep. A quarter of nulliparae (25%) and 18% of multipara had labour induction despite membrane sweep. Three quarters of both nulliparae (73%) and multipara (76%) delivered within 7 days of membrane sweep. In the presence of a Bishop score greater than six, the rate of spontaneous labour was 97% in our patient cohort. Nine in ten women (91%) had previously heard of cervical membrane sweep. Two in three women (65%) thought that membrane sweep helped them to labour, and over 80% would recommend it to other pregnant women despite 63% of women reporting moderate discomfort with the procedure. Conclusions Cervical membrane sweep is associated with spontaneous onset of labour within 7 days in the majority of patients, more so in the presence of higher Bishop score and better quality sweep. It has a high level of acceptability among patients and is highly recommended by them to other patients. The need for more than one membrane sweep is associated with less likelihood of spontaneous onset of labour.