Meconium is a black-green, odourless material first
demonstrable in the fetal intestine during the third month of gestation and it
results from the accumulation of debris.Passage of meconium slows down after 16
weeks and cease by 20 weeks of gestation. Almost all new-born infants who pass
meconium are mature (term).
However, in some cases; meconium passage may be associated
with umbilical cord compression or increased sympathetic inflow during hypoxia
and is also a potential toxin if the fetus
aspirates this particulate matter with a gasping breath in utero or when it
takes its first breaths following birth. In addition intrauterine exposure to
meconium is associated with inflammation of tissues of the lung, chorionic
plate and umbilical vessels and through various mechanisms may contribute to
neonatal morbidity, independent of MAS.
Meconium stained amniotic fluid (MSAF) occurs in 12 to 20%
of labouring mothers, and it is a confusing issue because it can be due to
either physiologic or a hypoxic insult to the fetus. Birth depression occurs in
20 to 33% of infants born through MSAF and is likely caused by chronic asphyxia
and infection that may lead to passage of meconium and fetal gasping. This
suggest that meconiumstained amniotic fluid should be regarded as a symptom
rather than a syndrome becoming more prevalent with increasing term and which might
be associated with higher levels of infection or asphyxia.
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