The Historical Practice of “Membrane Sweep” to Initiate Labour: Does it Have a Role in Contemporary Obstetric Practice?

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.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.Cochrane Systematic Review in 2001 [1] 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.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.We have analyzed the current systematic evidence on the "Membrane Sweep" to determine its efficacy.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.