Introduction
Maternal intrapartum fever is a common obstetric complication during
labor, usually defined as temperature higher than or equal to 38
℃1-3, but another few defined as over 37.4
℃4, occurred in
1.6% to 34% parturients1. A variety of causes
contribute to the etiology of intrapartum fever, including infective and
non-infective reasons. Infectious
factors, the least common explanation, mainly associate with clinical
chorioamnionitis, urinary tract infection, and upper respiratory tract
infection4-6. Additionally, most febrile patients
during childbirth are secondary to non-infectious agents, involving in
epidural analgesia, environmental temperature during labor, prolonged
labor time, maternal underlying diseases4, 6-8. Fever
during labor could trigger
adverse
obstetric effects, including
postpartum hemorrhage, dystocia,
cesarean delivery3,
9. In addition to the obstetric outcomes, adverse neonatal sequelae
contain low Apgar scores, neonatal sepsis, hypotonia, neonatal
encephalopathy,
epileptic seizure, respiratory
distress or asphyxia, and even infants death6, 9-11.
Thus, intrapartum fever deserves more attention because of its high
incidence and severe consequences.
Traditionally, general fever is often diagnosed by complete blood cell
count (CBC)12, 13, this is because the value of CBC
before and after fever alters. However, hardly publications describe the
change of CBC in parturients suffered from intrapartum fever during the
whole labor. Apart from this, some other new biomarkers,
such
as neutrophil-to-lymphocyte ratio (NLR)14,
platelet-to-lymphocyte ratio (PLR)15, as well as
monocyte-to-lymphocyte ratio (MLR)16, are increasingly
emerged as effective markers linked to the measure of inflammation and
expected to use for judging if a person has a fever. Similarly, this
field also do not extend to the study of the intrapartum fever.
Therefore, we focused on the pre-, intra-, and postpartum changing
situation of patients with intrapartum fever during the birth process in
this paper. In addition, the possibility of NLR, PLR, and MLR act as
biomarkers was explored. Furthermore, the results of vaginal discharge
culture in febrile mother were also observed.