• Laura Goetzl, Jose Rivers, Tracy Evans, Deborah R Citron, Barbara E Richardson, Ellice Lieberman, and Maya S Suresh.
• Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX 77030, USA.
• J Perinatol. 2004 Aug 1;24(8):471-5.

ObjectiveEpidural analgesia is associated with a four- to five- fold increase in noninfectious maternal fever in nulliparous women. Fever prophylaxis may safely reduce both unnecessary neonatal sepsis evaluations and the potential effect of fever on the fetus.Study DesignWe performed a randomized double-blind placebo-controlled study. Immediately after epidural placement, full-term nulliparas with a temperature of <99.5 degrees F received acetaminophen 650 mg or placebo, per rectum, every 4 hours. Tympanic membrane temperatures were measured hourly. Our power to detect an effect of acetaminophen treatment on maternal temperature over time was 90%.ResultsIn all, 21 subjects were randomized to each arm. Treatment with acetaminophen did not impact maternal temperature curves. Fever >100.4 degrees F was identical in the acetaminophen and placebo groups (23.8%, p=1.0). Neonatal surveillance blood cultures did not reveal occult infection.ConclusionsAcetaminophen prophylaxis prevented neither maternal hyperthermia nor fever secondary to epidural analgesia, suggesting that the mechanism underlying fever does not include centrally mediated perturbations of maternal thermoregulation.

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