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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Association between infection and fever in terminations of pregnancy using misoprostol: a retrospective cohort study

Authors: Tobias A. J. Nijman, Kevin G. J. A. Voogdt, Pim W. Teunissen, Patrick J. (JP) van der Voorn, Christianne J. M. de Groot, Petra C. A. M. Bakker

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

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Abstract

Background

Fever is a well-known side effect of misoprostol, but clinically difficult to distinguish from an intra uterine infection. The aim of this study was to determine the incidence of fever in terminations of pregnancy (TOP) using misoprostol and to evaluate fever as indication of intra uterine infection.

Methods

A retrospective cohort study was performed. Consecutive second trimester TOP with misoprostol between January 2008 and October 2012 were selected. We included 403 cases and determined the incidence of fever. To examine intra uterine infection as plausible cause of fever, pathological examination reports of placentas were reviewed for signs of infections.

Results

The incidence of fever was 42%. Logistic regression showed a dose dependent association between dosage misoprostol and degree of fever (OR 1.86; 95% CI: 1.3–2.7). There was no association between fever and epidural analgesia. Fever has a sensitivity of 55% and a specificity of 58% as a marker of intra uterine infection. The positive predictive value of fever for an intra uterine infection is 4% and the negative predictive value is 98%.

Conclusion

Administration of misoprostol for the indication TOP is strongly associated with fever during labor. Fever is a poor predictor of intra uterine infection in the context of TOP.
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Metadata
Title
Association between infection and fever in terminations of pregnancy using misoprostol: a retrospective cohort study
Authors
Tobias A. J. Nijman
Kevin G. J. A. Voogdt
Pim W. Teunissen
Patrick J. (JP) van der Voorn
Christianne J. M. de Groot
Petra C. A. M. Bakker
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-1188-1

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