In utero, meconium is released into the amniotic fluid in response to:

• A. Fetal asphyxia
• B. Maternal medications
• C. Placental insufficiency
• D. Infection

Answer: (A)

Fetal hypoxia (asphyxia) triggers a vagal-mediated response in the fetus that increases intestinal motility and relaxes the anal sphincter, causing meconium to be released into the amniotic fluid. This meconium in the amniotic fluid is a sign of fetal distress and compromise. While placental insufficiency or infection can contribute to distress, the direct trigger for in utero meconium passage is the hypoxic/asphyxic state of the fetus. Maternal medications do not directly cause meconium release in utero.