Benign fever following vaginal delivery

John W Ely; Jeffrey D Dawson; Angela S Townsend; Asha Rijhsinghani; Noelle C. Bowdler

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Journal article

Peer reviewed

Benign fever following vaginal delivery

John W Ely, Jeffrey D Dawson, Angela S Townsend, Asha Rijhsinghani and Noelle C. Bowdler

The journal of family practice, Vol.43(2), pp.146-151

08/01/1996

PMID: 08708624

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Abstract

BACKGROUND: In patients with fever following vaginal delivery, physicians must differentiate benign self-resolving fevers from fevers with more serious causes, especially endometritis. To help differentiate these clinical entities, we explored the characteristics and risk factors for benign "single-day" postpartum fever. METHODS: We conducted a retrospective cohort study of 2137 vaginal deliveries. Patients were randomly selected from the 25,687 vaginal deliveries that took place between 1979 and 1992 at The University of Iowa Hospitals and Clinics. The data were analyzed using odds ratios and multiple logistic regression. RESULTS: Benign fevers occurred in 3.3% of patients, while endometritis was diagnosed in 1.6%. After controlling for confounding variables, two clinical factors were independently associated with single-day fever: primiparity (odds ratio [OR], 3.4; 95% confidence interval [CI], 2.0 to 5.7) and use of a uterine pressure catheter (OR, 2.4; 95% CI, 1.5 to 3.7). These factors were not associated with endometritis. The first postpartum temperature elevation ( > or = 38.0 degrees C) occurred earlier in patients with single-day fever than in patients with endometritis (4.0 +/- 4.6 hours postpartum vs 30.2 +/- 27.0 hours postpartum, P < .001). The maximum temperature elevation was lower, on average, in patients with single-day fever than in patients with endometritis (38.2 degrees +/- 0.2 degrees C vs 38.9 degrees +/- 0.6 degrees C, P < .001). CONCLUSIONS: Single-day fever was more likely to occur in primiparous women and in women who were monitored with a uterine pressure catheter. Most women with benign single-day fevers had early low-grade fevers, whereas women with endometritis had higher fevers that occurred later in the postpartum period.

Pregnancy

Obstetrics and Gynecology

Adult

Body Temperature

Cohort Studies

Delivery

Obstetric

Diagnosis

Differential

Endometritis

Female

Fever

Humans

Logistic Models

Parity

Puerperal Disorders

Retrospective Studies

Time Factors

Uterine Monitoring

Details

Title: Subtitle: Benign fever following vaginal delivery
Creators: John W Ely
Jeffrey D Dawson
Angela S Townsend
Asha Rijhsinghani - University of Iowa
Noelle C. Bowdler - University of Iowa
Resource Type: Journal article
Publication Details: The journal of family practice, Vol.43(2), pp.146-151
PMID: 08708624
NLM abbreviation: J Fam Pract
ISSN: 0094-3509
eISSN: 1533-7294
Language: English
Date published: 08/01/1996
Academic Unit: Family and Community Medicine; Obstetrics and Gynecology
Record Identifier: 9983557116202771

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