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Fetal defaecation: is it a normal physiological process?

R M Kimble1, B Trudenger, D Cass

  • 1Douglas Cohen Department of Paediatric Surgery, New Children's Hospital, Westmead, NSW, Australia. Royk@nch.edu.au

Journal of Paediatrics and Child Health
|June 12, 1999
PubMed
Summary
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Fetal defecation, including meconium passage, is a normal physiological event in the second and third trimesters. While meconium staining in late gestation can indicate fetal hypoxia, it

Area of Science:

  • Perinatology
  • Fetal Physiology
  • Neonatal Health

Background:

  • Historically, late gestation fetal meconium passage was primarily linked to hypoxia.
  • Emerging evidence suggests meconium passage may be a normal physiological event earlier in gestation.

Purpose of the Study:

  • To investigate the physiological normalcy of fetal defecation and meconium passage throughout gestation.
  • To differentiate between physiological meconium passage and that associated with fetal distress.

Main Methods:

  • Analysis of amniotic fluid for bile pigment and enteric enzyme content.
  • Review of indirect evidence for fetal defecation in the third trimester.
  • Examination of rectosigmoid dilation in newborns with anorectal malformations.

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Main Results:

  • Amniotic fluid studies indicate meconium passage is a normal physiological event in the second trimester.
  • Indirect evidence suggests fetal defecation is also normal in the third trimester, though less conclusive.
  • Rectosigmoid dilation in anorectal malformations supports the concept of normal fetal colonic peristalsis.

Conclusions:

  • Fetal defecation and meconium passage are likely normal physiological processes during the second and third trimesters.
  • Meconium staining of amniotic fluid in late gestation should still be cautiously interpreted as potentially indicating fetal hypoxia.
  • The hypothesis of normal fetal colonic peristalsis and defecation is supported by findings in infants with anorectal malformations.