Table 1 Recommendations regarding membrane sweeping from NICE Inducing Labour Guideline

Membrane sweeping involves the examining finger passing through the cervix to rotate against the wall of the uterus, to separate the chorionic membrane from the decidua. If the cervix will not admit a finger, massaging around the cervix in the vaginal fornices may achieve a similar effect. For the purpose of this guideline, membrane sweeping is regarded as an adjunct to induction of labour rather than an actual method of induction.

The Bishop score is a group of measurements made by doing a vaginal examination and is based on the station, dilation, effacement (or length), position and consistency of the cervix. A score of 8 or more generally indicates that the cervix is ripe, or ‘favourable’ – when there is a high chance of spontaneous labour, or response to interventions made to induce labour.

1.3.1 Membrane sweeping

1.3.1.1 Prior to formal induction of labour, women should be offered a vaginal examination for membrane sweeping.

1.3.1.2 At the 40- and 41-week antenatal visits, nulliparous women should be offered a vaginal examination for membrane sweeping.

1.3.1.3 At the 41-week antenatal visit, parous women should be offered a vaginal examination for membrane sweeping.

1.3.1.4 When a vaginal examination is carried out to assess the cervix, the opportunity should be taken to offer the woman a membrane sweep.

1.3.1.5 Additional membrane sweeping may be offered if labour does not start spontaneously.