Pyrexia in pregnancy

There are many causes of pyrexia in pregnancy.

Seek expert advice.

Management includes:

• monitoring the temperature
  
  
• consider causes of pyrexia and treat appropriately
  
  
• blood cultures should be considered in any pregnant patient with a pyrexia of 38øC or over which doesn't resolve within 48 hours unless the illness can be confidently attributed to some other cause
  
  
• evaluation
  • seriously ill patients need hospital admission
  • consider referral with persistent fever
    
    
• antibiotics - consider a broad spectrum antibiotic such as amoxicillin- or erythyromycin if allergic to penicillin - in pregnant women with pyrexia of 38 degrees centigrade for 48 hours or more without waiting blood culture result (1)
  • co-amoxiclav (if not penicillin allergic) is suggested in the management of pyrexia in labour of unknown origin (37.8°C or greater) or puerperal sepsis (2)
  • check local prescribing guidelines for suggested antibiotic treatment
    
    
• assess foetal wellbeing with CTG and ultrasound if necessary

Reference:

• Dept of Health 9.12.92 PL/CMO(92)19. There is a lack of data to support this advice, but the recommendation is made on the basis that it has the potential to prevent serious disease in the foetus and antibiotics are relatively safe.
• Salisbury NHS Foundation Trust. Obstetric Antimicrobial Prescribing Guidelines (Accessed 22/6/2014)