ABSTRACT
To determine whether women who receive continuous epidural analgesia for labor and
delivery are more likely to receive antibiotic therapy compared to those parturients
who do not use epidural analgesia, a chart review was performed for 300 women, 100
in each group using narcotics alone, epidural alone, or parenteral narcotics followed
by epidural analgesia. While only 2% of women with narcotics alone developed an intrapartum
temperature ≥ 37.8°C, 16% and 24% of women with epidural use alone or in addition
to narcotics did so, respectively. Antibiotic administration was increased among women
utilizing epidural analgesia, exclusively or following parenteral narcotics. No parturient
with culture or pathological evidence of chorioamnionitis had maternal temperature
elevation as an isolated finding. A probable causal relationship between maternal
temperature elevation and epidural use in labor is supported. Rather than treating
all women with temperature elevations and epidurals for presumed chorioamnionitis,
it is reasonable to target treatment to those with fetal tachycardia, meconium stained
fluid, or abnormal amniotic fluid studies.
Keywords
Epidural analgesia - maternal fever - antibiotics
