Quality statement 12: Fetal wellbeing – membrane sweeping for prolonged pregnancy

Quality statement 12: Fetal wellbeing – membrane sweeping for prolonged pregnancy

Quality statement

Nulliparous pregnant women are offered a vaginal examination for membrane sweeping at their 40- and 41-week antenatal appointments, and parous pregnant women are offered this at their 41-week appointment.

Quality measure

Structure

Evidence of local arrangements to ensure that nulliparous pregnant women are offered a vaginal examination for membrane sweeping at their 40- and 41-week antenatal visits, and parous pregnant women are offered this at their 41-week appointment.

Data source: Local data collection.

Process

a) Proportion of nulliparous pregnant women attending a 40-week antenatal appointment who are offered a vaginal examination for membrane sweeping.

Numerator – the number of women in the denominator offered a vaginal examination for membrane sweeping.

Denominator – the number of nulliparous pregnant women attending a 40-week antenatal appointment.

b) Proportion of nulliparous pregnant women attending a 41-week antenatal appointment who are offered a vaginal examination for membrane sweeping.

Numerator – the number of women in the denominator offered a vaginal examination for membrane sweeping.

Denominator – the number of nulliparous pregnant women attending a 41-week antenatal appointment.

c) Proportion of parous pregnant women attending a 41-week antenatal appointment who are offered a vaginal examination for membrane sweeping.

Numerator – the number of women in the denominator offered a vaginal examination for membrane sweeping.

Denominator – the number of parous pregnant women attending a 41-week antenatal appointment.

Data source: a), b) and c) Local data collection.

Outcome

a) Rates of induction of labour for women with prolonged pregnancy.

b) Mode of delivery for women with prolonged pregnancy including:

  • spontaneous vaginal birth

  • instrumental vaginal birth

  • elective or emergency caesarean section.

c) Rates of stillbirth beyond 40 weeks gestation (where there is no underlying medical cause).

Data source: a), b) and c) Local data collection.

a), b) and c) The Maternity Services Secondary Uses Dataset, once implemented, will collect data on 'the medical induction of labour' (global number 17204740), 'the method for delivering baby' (global number 17206160) and neonatal death (global number 17209680).

What the quality statement means for each audience

Service providers ensure that systems are in place to offer nulliparous pregnant women a vaginal examination for membrane sweeping at their 40- and 41-week antenatal appointments, and parous pregnant women the same at their 41-week appointment.

Healthcare professionals offer nulliparous pregnant women a vaginal examination for membrane sweeping at their 40- and 41-week antenatal visits, and parous pregnant women the same at their 41-week appointment.

Commissioners ensure they commission services that offer nulliparous pregnant women a vaginal examination for membrane sweeping at their 40- and 41-week antenatal appointments, and parous pregnant women the same at their 41-week appointment.

Pregnant women having their first baby are offered a vaginal examination at their 40- and 41-week antenatal appointments to carry out a membrane sweep, in which a healthcare professional moves a finger around the cervix or massages the cervix, to help start labour.

Pregnant women having their second or later baby are offered a vaginal examination at their 41-week appointment to carry out membrane sweep, in which a healthcare professional moves a finger around the cervix or massages the cervix, to help start labour.

Source guidance