Analysis Of Influencing Factors Of Intrapartum Fever After Combined Spinal Epidural Block For Labor Analgesia

Objective:Intrapartum fever after labor analgesia may be related tomany factors,This study collected the basic information,delivery situation,inflammatory related indicators and other related information of the parturients who voluntarily asked for combined spinal epidural block labor analgesia in our hospital in the past year,and analyzed the collected data retrospectively,to explore the influencing factors that may lead to intrapartum fever after labor analgesia,in order to preprocess and reduce the incidence of intrapartum fever in the follow-up clinical work and to provide the basis for the incidence of fever related adverse events.Methods:The study was conducted on the parturient who entered the maternity room and was accompanied by lumbar hard block for labor analgesia from August 1st,2019 to July 31st,2020 in the Affiliated Hospital of Guilin Medical University.The final research object is determined according to the inclusion and exclusion criteria set in this study.The subjects included were divided into fever group and non fever group according to whether armpit temperature was higher than 37.5℃within 48 hours after labor analgesia.Collect the following data:(1)basic information of the pregnant women,such as:age,height,weight,BMI,whether it passes through the pregnant woman,whether it is a tube baby,whether it is combined with gestational diabetes mellitus,whether the mother is combined with GBS(+);(2)pregnancy and delivery,such as:amniotic fluid quantity,amniotic fluid turbidity,placental chorionic inflammation,etc.;membrane breaking mode,vaginal incision,perineum laceration,yin and vagina laceration The first labor period is long,the second labor process is long,and the amount of analgesics is used;(3)inflammatory indexes,such as WBC,10~9/L),absolute neutrophil count before analgesia(neut,10~9/L),leucocyte count after analgesia,absolute neutrophil count after analgesia,change of leukocyte count,neutrophil Absolute count change value.After the collected data information is summarized and tabulated,the data are processed by using IBM SPSS statistics 25software.The influencing factors that may lead to fever in the parturient after labor analgesia are studied.Results:In this study,a total of 513 parturients who were admitted to the delivery room for labor and received combined spinal epidural analgesia in the Affiliated Hospital of Guilin Medical University from August 1st,2019 to July 31st,2020 were selected as the research objects.162parturients had intrapartum fever(>37.5℃)after labor analgesia,and 351parturients had no intrapartum fever(<37.5℃),with a fever rate of 31.58%.In terms of the basic situation of the puerpera,the puerpera with relatively high age are more likely to have intrapartum fever after labor analgesia,while the height,weight,BMI,whether the puerpera is multipara,whether the puerpera is test tube baby,whether the puerpera has gestational diabetes mellitus and whether the mother has GBS infection(+)will not affect the occurrence of intrapartum fever after labor analgesia.Higher amniotic fluid turbidity and placental chorionic villitis may indicate fever.The longer the time of the second stage of labor,the total stage of labor and medication,the more likely there will be intrapartum fever after labor analgesia;however,the amount of amniotic fluid,rupture of membrane,vaginal lateral incision,perineal laceration,vaginal delivery mode,time of the first stage of labor,time of the third stage of labor and postpartum hemorrhage will not affect whether there will be intrapartum fever after labor analgesia.Finally,in terms of inflammatory indexes,WBC and neuc of the febrile group and the non febrile group were all around the upper limit of the normal range before labor analgesia,and there was no difference between the two groups.However,in the blood routine test after labor analgesia,WBC and neuc of the febrile group and the non febrile group were significantly increased,and there were significant differences between the re measured values and the difference between the increased values It is suggested that the combined analgesia of lumbar and epidural analgesia may lead to the increase of intrapartum inflammatory factors.Conclusion:The age,amniotic fluid contamination,the presence or absence of placental chorionic villitis,the time of the second stage of labor,the total time of labor,the duration of intraspinal administration,and the WBC and neuc values in the blood routine were the related factors to predict the occurrence of intrapartum fever.