Background: Green-stained amniotic fluid does not always indicate that meconium was passed in utero.
Case presentation: We report the case of a 2280-g Hispanic preterm female born at 32 weeks of gestation with congenital jejunal atresia. The amniotic fluid was greenish stained; the initial impression was meconium-stained amniotic fluid. Postnatal findings revealed no meconium in her rectum. The content of her first stool appeared sticky and white.
Conclusion: In the absence of meconium in the rectum, the pediatrician should consider the possibility that the greenish amniotic fluid is not meconium stained, but rather stained with bile due to the fetus vomiting in utero secondary to intestinal obstruction.
Keywords: Amniotic fluid; Bile-stained amniotic fluid; Intestinal obstruction; Neonate.