Association between infection and fever in terminations of pregnancy using misoprostol: a retrospective cohort study

BMC Pregnancy and Childbirth

Research Article

Tobias A. J. Nijman¹  Pim W. Teunissen²  Kevin G. J. A. Voogdt²  Petra C. A. M. Bakker²  Christianne J. M. de Groot²  Patrick J. (JP) van der Voorn³ 

[1] Department Obstetrics and Gynecology, Division Woman & Baby, UMC, Lundlaan 6, 3508 AB, Utrecht, The Netherlands;Department Obstetrics and Gynecology, VUmc, Amsterdam, The Netherlands;Department Pathology, VUmc, Amsterdam, The Netherlands;

关键词: Misoprostol;    Fever;    Termination of pregnancy;    Abortion;    Infection;   

DOI  :  10.1186/s12884-016-1188-1

 received in 2015-11-11, accepted in 2016-12-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundFever is a well-known side effect of misoprostol, but clinically difficult to distinguish from an intra uterine infection. The aim of this study was to determine the incidence of fever in terminations of pregnancy (TOP) using misoprostol and to evaluate fever as indication of intra uterine infection.MethodsA retrospective cohort study was performed. Consecutive second trimester TOP with misoprostol between January 2008 and October 2012 were selected. We included 403 cases and determined the incidence of fever. To examine intra uterine infection as plausible cause of fever, pathological examination reports of placentas were reviewed for signs of infections.ResultsThe incidence of fever was 42%. Logistic regression showed a dose dependent association between dosage misoprostol and degree of fever (OR 1.86; 95% CI: 1.3–2.7). There was no association between fever and epidural analgesia. Fever has a sensitivity of 55% and a specificity of 58% as a marker of intra uterine infection. The positive predictive value of fever for an intra uterine infection is 4% and the negative predictive value is 98%.ConclusionAdministration of misoprostol for the indication TOP is strongly associated with fever during labor. Fever is a poor predictor of intra uterine infection in the context of TOP.

【 授权许可】

CC BY   
© The Author(s). 2017