Epidural fever

Abstract

ABSTRACT

Epidural analgesia (EPA) is the most effective method of intrapartum pain relief and is considered to be very safe. Recently it has been in up to 34 % of parturients with EPA also associated with maternal temperature elevations during labor. The mechanism of this epidural-associated fever remains incompletely understood. The most likely etiology seems to be a non-infectious inflammation caused by epidural catheter. However, some authors deny this association. They theorize it's caused by selection bias only, as EPA is more often required by women with more painful and prolonged or more complicated labor, where a temperature elevation is due to other causes. They point out that in some studies the fever was correlated to EPA only with concurrent placental inflammation. Maternal fever, doesn´t matter the cause, either infectious or non infectious origin, carries important clinical and public health implications. Further research that evaluate maternal epidural status and its influence on maternal or neonatal fever, could improve sepsis evaluation and lead to worldwide decrease of unnecessary antibiotic exposure.