Intrapartum fever: A preliminary study

Abstract

Fever during labor may be due to dehydration, extragenital disease, or birth canal infection. The last is diagnosed by excluding the other two, or by the discharge of foul material from the tract. The primary lesion in infections of the genital tract is an amnionitis (placentitis) which subjects both the mother and the child to serious sequelae. In the mother, puerperal infection frequently develops and may be fatal, while aspiration pneumonia and septicemia by direct extension into the placental vessels constitute the chief risks to the child. In this series of 187 febrile labors, 129 presented evidence of birth canal infection alone or in combination with an extragenital factor. In the latter group, eight mothers and sixty-one infants died, mortality rates of 6.2 per cent and 46.9 per cent, respectively. Dehydration fever was followed by no maternal or fetal deaths, but pyrexia of extragenital origin (no evidence of uterine infection) led to a maternal death rate of 36.8 per cent and a fetal mortality rate of 42.2 per cent.Treatment of dehydration fever and of extragenital diseases followed usual lines. On the other hand, therapy of intrapartum birth canal infections has been significantly and favorably altered by recognition of the dangers involved and by the use of the newer antibiotics, the sulfonamides, and penicillin, prophylactically and curatively.