INCREASED INTRAPARTUM ANTIBIOTIC ADMINISTRATION ASSOCIATED WITH EPIDURAL ANALGESIA IN LABOR

To determine whether women who receive continuous epidural analgesia f or labor and delivery are more likely to receive antibiotic therapy co mpared to those parturients who do not use epidural analgesia, a chart review was performed for 300 women, 100 in each group using narcotics alone, epidural alone, or parenteral narcotics followed by epidural a nalgesia. While only 2% of women with narcotics alone developed an int rapartum temperature greater than or equal to 37.8 degrees C, 16% and 24% of women with epidural use alone or in addition to narcotics did s o, respectively. Antibiotic administration was increased among women u tilizing epidural analgesia, exclusively or following parenteral narco tics. No parturient with culture or pathological evidence of chorioamn ionitis had maternal temperature elevation as an isolated finding. A p robable causal relationship between maternal temperature elevation and epidural use in labor is supported. Rather than treating all women wi th temperature elevations and epidurals for presumed chorioamnionitis, it is reasonable to target treatment to those with fetal tachycardia, meconium stained fluid, or abnormal amniotic fluid studies.