PL.64 Pyrexia in Labour: Outcome and Management. (26th April 2013)

• Record Type: Journal Article
• Authors: Elsayed, S; Bozreiba, N; Khan, H; Cooley, S; Coulter-Smith, S
• Is Part Of: Archives of disease in childhood. Volume 98(2013)Supplement 1
• Page Start: A72
• Page End: A72
• Publication Date: 2013-04-26
• Subjects: Infants -- Diseases -- Periodicals; Newborn infants -- Diseases -- Periodicals; Fetus -- Diseases -- Periodicals; 618.920105
• DOI: 10.1136/archdischild-2013-303966.246
• Languages: English
• ISSNs: 1359-2998

Abstract

Abstract : Intrapartum fever can be due to an infectious or non-infectious aetiology and can lead to a variety of maternal and neonatal sequelae. Sepsis contributes significantly to maternal morbidity and mortality. Pyrexia may be the only symptom in early sepsis. 1 Aim: To evaluate the incidence, management and outcome of intra-partum pyrexia in the Rotunda hospital, and to evaluate adherence to new hospital guidelines regarding septic screen and antibiotic therapy in intra-partum pyrexia. Method: Rretrospective audit of practise between 1 August and 30 September 2012. The presence or absence of maternal risk factors were reviewed and included: antenatal Group B Streptococcus (GBS), antenatal infections, preterm prelabour rupture of membranes (PPROM), prolonged rupture of membranes (ROM) and epidural analgesia. Intra-partum course parameters: management of pyrexia including resource to septic screen and intravenous antibiotics were evaluated. Results: 41 cases were selected and reviewed. The incidence of pyrexia in labour was 2.7% over the study period. The median maternal age was 29. The median gestational age at delivery was 40. 80.5% were nulliparous. 5% had PPROM. 24% had prolonged spontaneous ROM (more than 18 hr). Only one woman was positive for GBS antenatally. 5 cases had GBS on HVS detected on septic screen and 1 case had GBS on placental swab. Labour was induced in 43.9%. 27% delivered by emergency LSCS and 39% by instrumental delivery. Conclusion: 88% of pyrexial women had a septic screen as per protocol. There was a poor culture lead from MSU with the highest yield from placental histology. Pyrexia in labour was associated with: Nulliparity, Induced labour, Prolonged ROM, Epidural analgesia and Operative delivery Reference: Maayan-Metzger A, Mazkereth R, Shani A, et al . Risk factors for maternal intrapartum fever and short-term neonatal outcome. Fetal Pediatr Pathol 2006;25:169.