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Obstetrics & Gynecology 2007;109:687-690
© 2007 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Intrapartum Epidural Analgesia and Maternal Temperature Regulation

Laura Goetzl, MD, MPH1, Jose Rivers, MD3, Israel Zighelboim, MD2, Ashutosh Wali, MD3, Martina Badell, MD4 and Maya S. Suresh, MD3

From the 1Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina; 2Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri; 3Department of Anesthesiology, Baylor College of Medicine, Houston, Texas; and 4Department of Obstetrics and Gynecology, Emory University, Atlanta, Georgia.

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






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