Meconium-stained amniotic fluid (MSAF) is the result of waste maternal from the fetal colon passing into the mother's amniotic cavity. Its incidence increases in post-term pregnancies. Pregnant women with MSAF are more likely to develop maternal complications including inflammation of the fetal membranes caused by a bacterial infection (chorioamnionitis), postpartum inflammation of the lining of the uterus (endometritis) and neonatal complications such as neonatal sepsis and need for admission to a neonatal intensive care unit (NICU) . Fetal stress or hypoxia may trigger gasping fetal respirations, which results in the aspiration of meconium.
Our review was based on one identified randomized controlled study (involving 120 women) and found that prophylactic antibiotics may reduce the risk of intra-amniotic infection in women with MSAF. Antibiotics use did not clearly reduce neonatal sepsis, NICU admission or postpartum endometritis. Studies with much larger numbers of pregnant women with MSAF would be needed to examine these issues.