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

1. 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.