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[Hyperthermia after obstetrical epidural anesthesia]

F J Mercier1, D Benhamou

  • 1Département d'Anesthésie-Réanimation, Hôpital Antoine-Béclère, Clamart.

Cahiers D'Anesthesiologie
|January 1, 1994
PubMed
Summary
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Epidural analgesia during labor can cause maternal hyperthermia, a rise in body temperature. This temperature increase is linked to labor duration and may affect fetal heart rate.

Area of Science:

  • Obstetrics and Gynecology
  • Anesthesiology
  • Maternal-Fetal Medicine

Context:

  • Epidural analgesia for labor differs from its use in surgery or cesarean delivery regarding thermoregulation.
  • Maternal hyperthermia during labor is a multifactorial phenomenon influenced by measurement site, ambient temperature, and labor progression.

Purpose:

  • To investigate the incidence and characteristics of maternal hyperthermia associated with epidural analgesia during labor.
  • To explore potential pathophysiological mechanisms and clinical implications of this hyperthermia.

Summary:

  • Epidural analgesia for labor, unlike in other surgical contexts, frequently leads to maternal hyperthermia.
  • This temperature increase, typically observed after 2-5 hours of analgesia and more pronounced in prolonged labor (especially in primiparae), correlates with fetal tachycardia but not infection.

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  • The proposed mechanism involves reduced heat loss (sweating, hyperventilation) during labor-induced heat production.

    • Impact:

    • Recognizing labor epidural-induced hyperthermia is crucial to prevent misdiagnosis of infection and avoid unnecessary interventions like antibiotics or operative delivery.
    • Potential adverse effects on the fetus are debated, prompting consideration of active maternal cooling strategies.
    • Understanding this phenomenon aids in appropriate clinical management and decision-making during labor.