|September 2006 · Vol. 18, No. 9
Membrane sweeping and GBS: A litigious combination?
Although it led to a defense verdict, a recent lawsuit suggests sweeping in a colonized patient can expose you to litigation
Cochrane Review: Membrane sweeping does not increase risk of maternal and neonatal infection
The only adverse effect of membrane sweeping was increased bleeding
Swept women had more spontaneous vaginal deliveries and shorter induction intervals
Chair, Department of Obstetrics and Gynecology, Albert Einstein Medical Center, Clinical Professor of Obstetrics and Gynecology, Jefferson Medical College, PhiladelphiaJay
Director, Division of General Obstetrics and Gynecology, Jefferson Medical College, Philadelphia
We’ve all done it. Stripping the membranes is an old, familiar method of separating the fetal membranes from the lower uterine segment, which is thought to trigger the local production of prostaglandins and hasten the start of contractions.1
Membrane stripping is a focus of controversy when it comes to the issue of group B streptococcus (GBS). This article looks at the literature on the subject and presents a recent legal case in which a woman colonized with GBS claimed membrane stripping was the proximate cause of her infant’s death. In the case, experts for the plaintiff testified that membrane sweeping in a women colonized with GBS is below the standard of care, despite evidence to the contrary. The case, which involved a 2-week jury trial, resulted in a defense verdict.