Epidural analgesia and maternal fever: a clinical and research update

Purpose of review Maternal fever following epidural analgesia complicates up to one-third of nulliparous labors. Although generally benign, maternal fever is associated with both excess healthcare costs and an increased risk of adverse maternal and neonatal outcomes; therefore, this topic is of interest to anesthesiologists, obstetricians and pediatricians alike. The purpose of this review is to examine the latest research on the topic of epidural-related maternal fever, with special focus on the clinical relevance of new information. Recent findings Research over the past 18 months has increased our understanding of the cause of epidural-related fever and brought additional supportive evidence that proactive labor management may decrease risk. Additionally, there were innovative investigations of potential pharmacologic interventions to reduce maternal, and potentially fetal, risk. Summary Significant research advances were made in the last 18 months around the topic of epidural-related fever, but major gaps in knowledge persist especially with understanding the precise mechanism. The most pressing area of research is the development of well tolerated and effective prophylactic interventions to prevent maternal and fetal exposure to hyperthermia and inflammation.