Intrapartum epidural analgesia and maternal temperature regulation.
OBJECTIVE
To examine maternal temperature changes after epidural analgesia.


METHODS
A prospective cohort of nulliparas at term was monitored with hourly maternal tympanic temperatures after epidural analgesia (n=99). Temperature response after epidural analgesia was examined in the group as a whole. Subsequently, mean maternal temperature curves were compared between women who remained afebrile throughout labor (n=77) and women who developed intrapartum fever with body temperature greater than 100.4 degrees F (n=22). Baseline maternal characteristics were assessed.


RESULTS
Women who later developed intrapartum fever had a higher mean temperature within 1 hour after epidural analgesia. In contrast, women who remained afebrile had no increase in core temperature. During the first 4 hours after epidural analgesia initiation, women who later develop intrapartum fever have an increase in mean tympanic temperature of 0.33 degrees F per hour.


CONCLUSIONS
Epidural analgesia is not associated with increased temperature in the majority of women. Hyperthermia is an abnormal response confined to a minority subset, which occurs immediately after exposure. Our findings do not support a universal perturbation of maternal thermoregulation after epidural analgesia.


METHODS
II.
Goetzl
Laura
L
Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. goetzl@musc.edu
Rivers
Jose
J
Zighelboim
Israel
I
Wali
Ashutosh
A
Badell
Martina
M
Suresh
Maya S
MS
D000328:Adult; D015360:Analgesia, Epidural; D001833:Body Temperature Regulation / Q000502:physiology*; D005260:Female; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D011247:Pregnancy; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000503:physiopathology*; D013997:Time Factors