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fever after epiduralFrom: maggie cnm (maggiela@rochester.rr.com)Sat Dec 30 11:18:11 2000
Opinions, please. G3P2 in for AROM and pit augmentation at term. (Too many details as to why, etc and not really important to question.) AROM clear fluid at 3 cms. Labs normal, WBC 18.2.(We use 20 as significant) Labor progressed well with minimal pitocin. Pt requested and received an epidural at 4 cms (around 5pm). VS all normal,temp 37.4,pulse~100 (had been that way at admission). At 6pm, pt's temp was 38.6. Started her on Clinda (PCN allergy) with plans to add Gent but she delivered as the first Clinda ran in. Temp at delivery 39. Plan was to continue the atbx for overnight and see if she became afebrile. Baby was fine...off to special care because of maternal temp. Nothing suspicious about the placenta or amniotic fluid, etc. Is it possible that this was some type of response to the bupivicaine or fentanyl in the epidural? Anesthesia said that it was not, but since she was fine prior to the epidural, I wonder. Certainly this could have been chorio but she was AROMed only 2 hours prior to giving birth. I have read a few studies that show a correlation between maternal temps and epidural use but it seems that the temp elevates only after a few hours with the epidural in place. Thanks for your opinions....
-- Maggie, CNM
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