Macaulay J H, Bond K, Steer P J
Academic Department of Obstetrics and Gynecology, Charing Cross and Westminster Medical School, London, United Kingdom.
Obstet Gynecol. 1992 Oct;80(4):665-9.
To assess the effect of epidural analgesia on fetal temperature in labor, contrasting intrauterine with oral thermometry.
Fetal skin and maternal uterine wall temperatures were measured with an intrauterine probe in 57 laboring women at term. Maternal oral temperatures were measured in the normal way by birth attendants unaware that their measurements would be examined. Maximum recorded fetal, uterine, and oral temperatures were compared.
Epidural analgesia resulted in a significant fetal temperature rise compared with other methods of analgesia. Duration of epidural analgesia correlated with the fetal temperature (R = 0.44, P = .012). Oral thermometry underestimated fetal temperature in 95% of the studies.
We estimate that 5% of fetuses reached a core temperature in excess of 40C in this study, all in association with epidural analgesia. We suggest that antipyretic measures be considered after 5 hours of epidural analgesia in ambient temperatures above 24C.
评估硬膜外镇痛对产时胎儿体温的影响，对比宫内测温与口腔测温。
采用宫内探头测量57名足月分娩妇女的胎儿皮肤温度和母体子宫壁温度。由接生人员以常规方式测量母体口腔温度，他们不知道所测数据会被检查。比较记录的胎儿、子宫和口腔最高温度。
与其他镇痛方法相比，硬膜外镇痛导致胎儿体温显著升高。硬膜外镇痛持续时间与胎儿体温相关（R = 0.44，P = 0.012）。在95%的研究中，口腔测温低估了胎儿体温。
我们估计在本研究中有5%的胎儿核心体温超过40℃，均与硬膜外镇痛有关。我们建议在环境温度高于24℃时，硬膜外镇痛5小时后应考虑采取退热措施。
