A decrease in stress tolerance of chorioamniotic membranes when exposed to meconium has previously been demonstrated. Clinically, variations in elastic qualities of membranes can be appreciated during their removal following spontaneous vaginal deliveries. The purpose of this study was to determine if there is a relationship between the presence of meconium-stained amniotic fluid and difficulty in removal of chorioamniotic membranes in spontaneous vaginal deliveries. All deliveries over four months (n = 400) were evaluated for color of amniotic fluid and method of delivery of membranes. Overall, the CNMs used significantly more intervention to deliver the membranes if any meconium was present in the amniotic fluid prior to delivery (Fisher's exact test, P = .000004, df = 1). These results suggest that the accoucheur should be prepared for difficulty in membrane removal in deliveries complicated by meconium-stained fluid.
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