目的探讨羊水胎粪污染的产科处理的时机与方法。方法对2007年1月～2008年10月在我院分娩的羊水有胎粪污染的足月妊娠的产妇132例,进行回顾性分析,其中破膜时羊水粪染(A组)86例,产程中羊水由清亮变为胎粪污染(B组)36例,随机选择对同期产程中羊水清亮的430例足月妊娠的产妇作为对照组。结果羊水胎粪污染的发生率9.19%,粪染组在母体合并症,胎监异常,脐血流异常,新生儿窒息及剖宫产率均高于对照组。A组脐血流异常明显高于B组,B组胎心监护异常及新生儿窒息明显高于A组,A、B两组间母体合并症,剖宫产无明显差异。羊水粪染组中剖宫产与阴道分娩的新生儿窒息率有显著差异。结论重视羊水粪染的临床处理。在伴发母体合并症,脐血流异常,胎心监护异常情况下,及产程中羊水由清亮变为粪染时处理需积极,应该及早剖宫产为宜。如果是经产妇可在严密监护下阴道分娩。 Objective To investigate the timing and methods of obstetric treatment of meconium-stained amniotic fluid. Methods From January 2007 to October 2008, 132 cases of full-term pregnant women who had meconium-stained amniotic fluid in our hospital were retrospectively analyzed. 86 cases of amniotic fluid meningitis (group A) Amniotic fluid changed from clear to meconium-stained (group B) 36 cases were randomly selected for the same period of labor in amniotic fluid clear 430 cases of full-term pregnant women as a control group. Results The incidence of meconium-stained amniotic fluid was 9.19%. The incidences of maternal complications, abnormal fetal monitoring, umbilical cord blood flow abnormalities, neonatal asphyxia and cesarean section were higher in the meconium-stained group than those in the control group. The abnormal umbilical cord blood flow in group A was significantly higher than that in group B. The abnormal fetal heart rate monitoring and neonatal asphyxia in group B were significantly higher than those in group A. There was no significant difference in maternal complications between groups A and B. Amniotic fluid meconium-stained cesarean section and vaginal delivery of newborns with asphyxia were significantly different. Conclusion The clinical treatment of meconium-stained amniotic fluid is emphasized. In maternal complications, umbilical cord blood flow abnormalities, fetal heart rate monitoring anomalies, and labor process amniotic fluid from clear to meconium-stained treatment should be actively treated, cesarean section should be appropriate as soon as possible. If the maternal can be under close guardian vaginal delivery.