Insufficient evidence for prophylactic antibiotics for women with meconium-stained amniotic fluid

January 01, 0001

Insufficient evidence for prophylactic antibiotics for women with meconium-stained amniotic fluid

Clinical Question: How effective are prophylactic antibiotics for meconium-stained amniotic fluid (MSAF) during labour in preventing maternal and neonatal infections?

Bottom line: Compared to placebo, antibiotics for MSAF in labour may reduce chorioamnionitis. There was no evidence antibiotics could reduce postpartum endometritis, neonatal sepsis and neonatal intensive care unit (NICU) admission. No serious adverse effects were reported.

Caveat: This review was based on a single study involving 120 participants. The trial was of high methodological quality, based on adequate random allocation concealment. However, the sample size was not big enough to reach any firm conclusions.

Context: Pregnant women with MSAF are more likely to develop maternal complications, including chorioamnionitis and endometritis, and neonatal complications, such as neonatal sepsis, and the need for admission to a NICU. Foetal stress or hypoxia may trigger gasping foetal respirations which result in the aspiration of meconium.

Cochrane Systematic Review: Siriwachirachai T et al. Antibiotics for meconium-stained amniotic fluid in labour for preventing maternal and neonatal infections. Cochrane Reviews, 2010, Issue 12. Article No. CD007772. DOI:10.1002/14651858. CD007772.pub2. This review contains 1 study involving 120 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 311, May 2011.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: W. Pragnancy, Family Planning. Keywords: meconium-stained, amniotic fluid, antibiotic, prophylaxis, childbirth
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 9 August 2011

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.