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EFFECT OF MECONIUM ON DELIVERY OF CHORIOAMNIOTIC MEMBRANES

Authors

  • Mavis N. Schom CNM, MS,

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    • Mavis N. Schom received her B.S.N. degree in 1981 from the University of Texas in Austin, her M.S. degree in 1987 from Texas Woman's University in Houston, and her nurse-midwifery education from Baylor College of Medicine in Houston in 1990. Currently, she is an Instructor in Clinical Obstetrics, Gynecology, and Reproductive Sciences of the University of Texas Health Science Center at Houston and practices midwifery at the Lyndon Baines Johnson Hospital in Houston, Texas.

  • Jorge D. Blanco MD,

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    • Jorge D. Blanco received his B.A. degree from Johns Hopkins University in 1971, received his M.D. degree from Vanderbilt University in 1975, completed a residency in obstetrics and gynecology, and completed a matemal–fetal medicine fellowship at the University of Texas Health Sciences Center in San Antonio in 1979 and 1981, respectively. Currently, he is the John T. Armstrong Professor of Obstetrics and Gynecology and ViceChairman of the Department of Obstetrics, Gynecology, and Reproductive Sciences at the University of Texas Health Science Center at Houston. He is the Chief of Obstetrics and Gynecology at the Lyndon Baines Johnson Hospital in Houston, Texas.

  • Angelina N. Chambers CNM, MSN,

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    • Angelina N. Chambers received her master's degree in nurse-midwifery from Yale University in 1981. She is an Instructor in Clinical Obstetrics, Gynecology, and Reproductive Sciences at the University of Texas Health Science Center at Houston and is also the Director of the Nurse-Midwifery Service at Lyndon Baines Johnson Hospital in Houston, Texas.

  • Carol A. Rafferty BSN, CNM

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    • Carol A. Rafferty received her B.S.N. degree in 1978 from Houston Baptist University and her nurse-midwifery education from Baylor College of Medicine in Houston in 1985. Currently, she is an Instructor in Clinical Obstetrics, Gynecology, and Reproductive Sciences of the University of Texas Health Science Center at Houston and practices midwifery at the Lyndon Baines Johnson Hospital in Houston, Texas.


LBJ Hospital, Department of OB/GYN. 5656 Kelley, Houston, TX 77026.

ABSTRACT

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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