Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Department of Anesthesiology, Women and Children's Hospital, School of Medicine, Xiamen University, Xiamen, China.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):5354-5362. doi: 10.1080/14767058.2021.1879042. Epub 2021 Jan 27.
To use continuous real-time monitoring of maternal core body temperature during labor and investigate the association between epidural analgesia, intrapartum maternal fever, and maternal and neonatal outcomes.
Among 201 pregnant women attending our institution for a vaginal in-hospital delivery, 159 women received epidural analgesia and 42 women did not receive epidural analgesia. Women's core body temperature was continuously monitored for the duration of labor using a smartphone/iPad-connected wireless thermometer positioned in an axilla. The primary outcome was a change in maternal core body temperature during labor. Among women receiving epidural analgesia, maternal and neonatal outcomes were compared in women who developed an intrapartum fever and those who had no intrapartum temperature elevation.
Of the women receiving epidural analgesia, 26.4% ( = 42/159) developed intrapartum fever ≥38 °C compared to 7.1% ( = 3/42) of women not receiving epidural analgesia. Among those receiving epidural analgesia, women who developed intrapartum fever had a significantly longer first stage of labor and a higher incidence of cesarean section, assisted vaginal delivery, intrapartum hemorrhage, and turbid amniotic fluid compared to women with no intrapartum temperature elevation. Neonates of women who developed intrapartum fever had lower 1- and 5-min Apgar scores compared to neonates of women with no intrapartum temperature elevation; however, the difference was not significant.
This study used a precise and accurate method to monitor core body temperature among women receiving epidural analgesia. Results showed that the use of epidural analgesia during labor was associated with intrapartum maternal fever in all stages of labor. Fever after epidural analgesia was associated with adverse maternal outcomes, independent of neonatal complications.
通过对产妇产时核心体温进行连续实时监测，探讨硬膜外镇痛、产时产妇发热与母婴结局的关系。
在我院 201 名接受阴道住院分娩的孕妇中，159 名孕妇接受了硬膜外镇痛，42 名孕妇未接受硬膜外镇痛。使用智能手机/ iPad 连接的无线温度计连续监测产妇产时核心体温，温度计置于腋窝。主要结局为产时产妇核心体温变化。在接受硬膜外镇痛的孕妇中，比较了产时发热和无产时体温升高的孕妇的母婴结局。
接受硬膜外镇痛的孕妇中，26.4%（42/159）发生产时发热≥38°C，而未接受硬膜外镇痛的孕妇中，7.1%（3/42）发生产时发热。在接受硬膜外镇痛的孕妇中，与无产时体温升高的孕妇相比，发生产时发热的孕妇第一产程明显延长，剖宫产、辅助阴道分娩、产时出血和羊水浑浊的发生率更高。与无产时体温升高的孕妇相比，发生产时发热的孕妇新生儿 1 分钟和 5 分钟 Apgar 评分较低，但差异无统计学意义。
本研究采用精确、准确的方法监测接受硬膜外镇痛的产妇的核心体温。结果表明，产时使用硬膜外镇痛与各产程产妇发热有关。硬膜外镇痛后发热与产妇不良结局有关，与新生儿并发症无关。
