Articles  |   January 2018
SEE Question
Article Information
Obstetric Anesthesia / Pain Medicine / Articles
Articles   |   January 2018
SEE Question
ASA Monitor 01 2018, Vol.82, 38-39.
ASA Monitor 01 2018, Vol.82, 38-39.
According to a recent review article, all of the following mechanisms have been proposed as primary etiologies for epidural-related maternal fever (ERMF) except:
ERMF occurs in approximately 20 percent of women receiving epidural analgesia during labor. Maternal fever in general has been associated with increased maternal interventions, including antibiotic administration, cervical/uterine instrumentation, and cesarean delivery. Because the cause of fever may be multifactorial, the authors of a recent review article considered many possible etiologies for ERMF in an attempt to improve understanding, decrease the prevalence of ERMF, and find effective prevention strategies.
Although several common triggers exist for maternal fever, none seem able to explain the relatively high occurrence of ERMF. Although it may seem intuitive for chorioamnionitis or another infectious process to be the etiology of ERMF, chorioamnionitis is estimated to occur in only 3 percent to 5 percent of births in the United States while 20 percent of women who receive epidural analgesia experience ERMF. Furthermore, researchers in a double-blind, placebo-controlled, adequately powered trial found that prophylactic antibiotic therapy failed to prevent ERMF, thereby suggesting an etiology for ERMF that is not infectious.
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