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From Greek mēkōnion, meaning poppy juice.

Greenish-black, sticky excretion from the neonatal bowel. Produced from the second trimester (12-16 weeks) until birth.

Meconium is usually passed within 24 hours of birth. May however be passed in utero, usually in response to fetal distress during labour. Meconium aspiration syndrome is a chemical pneumonitis which may be superimposed on any hypoxic/ischaemic insult suffered during labour. Direct tracheal suction at birth may be useful in certain situations where meconium is present but is not routinely advised.[1] Amnioinfusion has also been suggested as a preventative measure.[2]

Intra-partum passage of meconium by a preterm baby has been described in neonatal Listeria infection, but is a very non-specific sign.[3]

Meconium ileus complicated by volvulus and subsequent infarction. The thick inspissated meconium can be seen extruding from the cut-end of the bowel.

Delayed passage of meconium can be a sign of bowel dysfunction, specifically Hirschsprung disease or cystic fibrosis. Approximately 80% of normal term neonates pass meconium within 24 hours, about 95% within 48 hours.

Subacute bowel obstruction in cystic fibrosis was previously called meconium ileus equivalent but is more appropriately called distal intestinal obstruction syndrome as it typically occurs much later, by which time meconium has already been passed.