The midwife does this by stripping the membranes from the cervix wall. Patients are followed until the time of delivery, which is within 6 weeks of enrollment for most women. One way to speed up labour is to stimulate the uterus. Many women find the procedure uncomfortable or even painful, but it only lasts a few minutes. Randomization is the real research portion of this study, since offering membrane sweeping is already the standard of care. Membrane stripping (also known as a membrane sweep) is a procedure done to help induce labor if you're full term and your cervix is already somewhat dilated. The investigators secondary objectives are to measure the effect of membrane sweeping on pregnancy duration, length of labor and adverse events potentially related to membrane sweeping such as maternal chorioamnionitis and neonatal morbidity. The investigators primary objective is to determine whether membrane sweeping in GBS positive women is associated with inadequate antibiotic treatment in labor (defined as less than four hours of antibiotic therapy prior to delivery). In order to help elucidate the effect of membrane sweeping in GBS positive patients, the investigators propose this prospective randomized trial. Therefore, data are insufficient to encourage or discourage this practice". Membrane sweeping, also known as membrane stripping, is a procedure that can help induce labor in pregnant people who are close to or past their due date. ACOG guidelines state "the risks of membrane stripping in GBS positive patients has not been investigated in well-designed, prospective studies. A meta-analysis did not show a difference in neonatal or maternal infection rates between women who underwent membrane sweeping and those who did not. Based on the theoretical increased risk of bacterial seeding after membrane sweeping, as well as concern for fast labors and inadequate treatment after membrane sweeping, some practitioners choose not to sweep membranes in GBS positive patients. The relationship between early onset GBS disease and sweeping of the membranes is not known. Early onset GBS disease has become rare since the widespread use of GBS screening and prophylactic treatment of pregnant women. Early onset GBS disease in the newborn can lead to pneumonia, meningitis, and sepsis, all of which can be life-threatening. Newborn infants can also acquire GBS infection during passage through the vagina. In pregnant women, GBS can cause urinary tract infections, chorioamnionitis, and postpartum endometritis. Group B streptococcus (GBS streptococcus agalactiae) is a gram positive coccus that frequently colonizes the human genital tract. Thus, it is a safe and practical option for women who wish to avoid inductions of labor or postterm pregnancies. The efficacy of membrane sweeping is well studied, and has been shown to increase the number of patients in labor within 72 hours, reduce the frequency of pregnancy continuing beyond 41 or 42 weeks, and reduce the frequency of formal induction of labor. The process of membrane sweeping probably causes release of prostaglandins from the decidua and the cervix. Sweeping or stripping of the membranes (in this paper referred to as "membrane sweeping") is a widely utilized technique to hasten delivery for women at 37+ weeks gestation. Why Should I Register and Submit Results?.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |