Obstetrics & Gynecology

Skip Navigation LinksHome > March 2007 - Volume 109 - Issue 3 > Intrapartum Epidural Analgesia and Maternal Temperature Regu...
Obstetrics & Gynecology:
doi: 10.1097/01.AOG.0000255976.14297.f6
Original Research

Intrapartum Epidural Analgesia and Maternal Temperature Regulation

Goetzl, Laura MD, MPH; Rivers, Jose MD; Zighelboim, Israel MD; Wali, Ashutosh MD; Badell, Martina MD; Suresh, Maya S. MD

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Abstract

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 100.4ºF (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 0.33ºF per hour.

CONCLUSION: 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.

LEVEL OF EVIDENCE: II

© 2007 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.

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