Greenwell, E., Wyshack, G., Lise, R., Michael, J. & Ellice, L. (2012). Intrapartum temperature elevation, epidural use, and adverse outcome in term infants. Pediatrics Volume, 129(2), 447- 454.
This article was authored through a collaboration of various paediatricians. Various medical schools and hospitals contributed towards the research of this article. The article covers research on the association between elevation of intrapartum temperature and neonatal outcomes in patients administered with epidural analgesia (Greenwell et al., 2012). The research was focused on those women with singleton pregnancies that were less than thirty-seven weeks old. Neonatal outcomes for groups who were receiving an epidural and those who were not were then compared. The results were then correlated with intrapartum temperature evaluation. According to the article, the results of this research indicated an increase in temperature for those women who not receiving an epidural. Majority of those who received an epidural recorded a temperature of less than a hundred point four degrees. When it came to adverse neonatal outcomes, no significant differences were observed. The research concluded that high temperatures during birth might have adverse effects for a foetus. On the other hand, there were no notable differences in neonatal outcomes between women receiving an epidural and those not receiving one. In addition, it was observed that undetected cases of maternal infections could have been responsible for the some of the recorded adverse outcomes. This research was meant to shed light on issues surrounding epidural administration, intrapartum temperatures, and adverse neonatal effects.
Lieberman, E., Lang, J., Richardson, D., Frigoletto, F., Hefner, L. & Cohen, A. (2000). Intrapartum Maternal Fever and Neonatal Outcome. Pediatrics, 105(1), 8-13.
The National Institute of Child Health and Human development supported the research on this article. The article covers research that was done to investigate the relationship between elevated maternal temperatures and neonatal outcomes. The research was limited to instances when the infants did not develop an infection. The study was focused on 1218 women with singleton pregnancies and spontaneous labour (Lieberman et al., 2000). Women who had diabetes, herpes, or whose infants developed complications were excluded from the study. The results of the research indicate that women who received an epidural were more likely to develop a fever. It was also evident that those women who developed a fever had longer gestations. The state of newborns and the timing of infant seizures were not related to fevers. The article therefore concluded that administration of epidurals increased the chances of a fever. This fever increased the chances of complications. Among the limitations of the study is that nurses and paediatricians may have assigned different Apgar scores at birth. The article also calls for additional research on this topic.
Synder, M., Crawford, P. & Jamieson, B. (2007). What treatment approach to intrapartum maternal fever has the best foetal outcomes? The Journal of Family Practice, 56(5), 401-402.
Two medical practitioners authored this article. The article is an answer to the question about which treatment of intrapartum maternal fever results in minimal complications for the foetus (Synder, Crawford & Jamieson, 2007). The authors base their answers on previous research and prior experience. First, the article recommends use of antibiotics to treat acute chorioamnionitis. According to the article, other signs of this condition should be confirmed first. Acute chorioamnionitis includes maternal fever, uterine tenderness, purulent amniotic fluid, and maternal tachycardia. Its chances of resulting in a fatality are about one to two percent. There is research to indicate that intrapartum antibiotics may reduce sepsis. The confidence levels of this approach are about ninety-five percent. However, this research used a small sample size therefore making it unreliable. The study also suggested mixing ampicilin with clindamycin to increase efficiency. Other recommendations include administering an ampicilin dosage every two to four hours. Clindamycin is used to replace amoxicillin in patients who are allergic to penicillin. This article represents the authors’ honest opinions on the best method of treatment.