Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour

Manuel C. Vallejo, Bupesh Kaul, Lauri J. Adler, Amy L. Phelps, Catherine M. Craven, Trevor A. Macpherson, Richard L Sweet, Sivam Ramanthan

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Purpose: Maternal fever is associated with chorioamnionitis and has been linked to labour epidural analgesia (LEA). The purpose of this study was to determine possible associations between LEA and chorioamnionitis, maternal fever, operative delivery rate, and neonatal outcome. Methods: Data from 14,073 patients were entered into a database over a two-year period. From this database, 62 nulliparous parturients with clinical chorioamnionitis (amnionitis), but without LEA were identified (Group I). Two other groups who received LEA were matched for parity and gestation: Group II - LEA with concomitant amnionitis (n=50) and, Group III - LEA without concomitant amnionitis (n=201). The diagnosis of chorioamnionitis was confirmed by histologic examination. Results are expressed as mean ± SD and analyzed at P <0.05 using ANOVA or Chi-square. Results: No differences were noted among the groups in the operative delivery rate or Apgar scores at five minutes. The percentage of patients with maternal fever during labour (38.0°C) with amnionitis was significantly less in Group III compared to the other groups (100% in both Groups I and II vs 1.0% in Group III; P=0.000). Likewise, Group III had a lower percentage of neonates with Apgar scores <7 at one minute (35.5% in Group I,20.0% in Group II, 17.4% in Group III; P=0.010). The percentage of histologic chorioamnionitis was significantly higher in both amnionitis groups compared to Group III (67.7% in Group I, 56.0% in Group II, 4.0% in Group III; P=0.000). Conclusion: LEA without chorioamnionitis is not associated with maternal fever (38.0°C), increased operative delivery rates or low Apgar scores.

Original languageEnglish (US)
Pages (from-to)1122-1126
Number of pages5
JournalCanadian Journal of Anesthesia
Volume48
Issue number11
StatePublished - 2001
Externally publishedYes

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Chorioamnionitis
Epidural Analgesia
Fever
Mothers
Apgar Score
Databases
Parity
Analysis of Variance

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Vallejo, M. C., Kaul, B., Adler, L. J., Phelps, A. L., Craven, C. M., Macpherson, T. A., ... Ramanthan, S. (2001). Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour. Canadian Journal of Anesthesia, 48(11), 1122-1126.

Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour. / Vallejo, Manuel C.; Kaul, Bupesh; Adler, Lauri J.; Phelps, Amy L.; Craven, Catherine M.; Macpherson, Trevor A.; Sweet, Richard L; Ramanthan, Sivam.

In: Canadian Journal of Anesthesia, Vol. 48, No. 11, 2001, p. 1122-1126.

Research output: Contribution to journalArticle

Vallejo, MC, Kaul, B, Adler, LJ, Phelps, AL, Craven, CM, Macpherson, TA, Sweet, RL & Ramanthan, S 2001, 'Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour', Canadian Journal of Anesthesia, vol. 48, no. 11, pp. 1122-1126.
Vallejo MC, Kaul B, Adler LJ, Phelps AL, Craven CM, Macpherson TA et al. Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour. Canadian Journal of Anesthesia. 2001;48(11):1122-1126.
Vallejo, Manuel C. ; Kaul, Bupesh ; Adler, Lauri J. ; Phelps, Amy L. ; Craven, Catherine M. ; Macpherson, Trevor A. ; Sweet, Richard L ; Ramanthan, Sivam. / Chorioamnionitis, not epidural analgesia, is associated with maternal fever during labour. In: Canadian Journal of Anesthesia. 2001 ; Vol. 48, No. 11. pp. 1122-1126.
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abstract = "Purpose: Maternal fever is associated with chorioamnionitis and has been linked to labour epidural analgesia (LEA). The purpose of this study was to determine possible associations between LEA and chorioamnionitis, maternal fever, operative delivery rate, and neonatal outcome. Methods: Data from 14,073 patients were entered into a database over a two-year period. From this database, 62 nulliparous parturients with clinical chorioamnionitis (amnionitis), but without LEA were identified (Group I). Two other groups who received LEA were matched for parity and gestation: Group II - LEA with concomitant amnionitis (n=50) and, Group III - LEA without concomitant amnionitis (n=201). The diagnosis of chorioamnionitis was confirmed by histologic examination. Results are expressed as mean ± SD and analyzed at P <0.05 using ANOVA or Chi-square. Results: No differences were noted among the groups in the operative delivery rate or Apgar scores at five minutes. The percentage of patients with maternal fever during labour (38.0°C) with amnionitis was significantly less in Group III compared to the other groups (100{\%} in both Groups I and II vs 1.0{\%} in Group III; P=0.000). Likewise, Group III had a lower percentage of neonates with Apgar scores <7 at one minute (35.5{\%} in Group I,20.0{\%} in Group II, 17.4{\%} in Group III; P=0.010). The percentage of histologic chorioamnionitis was significantly higher in both amnionitis groups compared to Group III (67.7{\%} in Group I, 56.0{\%} in Group II, 4.0{\%} in Group III; P=0.000). Conclusion: LEA without chorioamnionitis is not associated with maternal fever (38.0°C), increased operative delivery rates or low Apgar scores.",
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AU - Vallejo, Manuel C.

AU - Kaul, Bupesh

AU - Adler, Lauri J.

AU - Phelps, Amy L.

AU - Craven, Catherine M.

AU - Macpherson, Trevor A.

AU - Sweet, Richard L

AU - Ramanthan, Sivam

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N2 - Purpose: Maternal fever is associated with chorioamnionitis and has been linked to labour epidural analgesia (LEA). The purpose of this study was to determine possible associations between LEA and chorioamnionitis, maternal fever, operative delivery rate, and neonatal outcome. Methods: Data from 14,073 patients were entered into a database over a two-year period. From this database, 62 nulliparous parturients with clinical chorioamnionitis (amnionitis), but without LEA were identified (Group I). Two other groups who received LEA were matched for parity and gestation: Group II - LEA with concomitant amnionitis (n=50) and, Group III - LEA without concomitant amnionitis (n=201). The diagnosis of chorioamnionitis was confirmed by histologic examination. Results are expressed as mean ± SD and analyzed at P <0.05 using ANOVA or Chi-square. Results: No differences were noted among the groups in the operative delivery rate or Apgar scores at five minutes. The percentage of patients with maternal fever during labour (38.0°C) with amnionitis was significantly less in Group III compared to the other groups (100% in both Groups I and II vs 1.0% in Group III; P=0.000). Likewise, Group III had a lower percentage of neonates with Apgar scores <7 at one minute (35.5% in Group I,20.0% in Group II, 17.4% in Group III; P=0.010). The percentage of histologic chorioamnionitis was significantly higher in both amnionitis groups compared to Group III (67.7% in Group I, 56.0% in Group II, 4.0% in Group III; P=0.000). Conclusion: LEA without chorioamnionitis is not associated with maternal fever (38.0°C), increased operative delivery rates or low Apgar scores.

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