first PP temp after epidural?

Elvish, BSN, DNP, RN, NP · Jul 15, 2011

We don't usually see lower temps postpartum unless there is something else going on. But usually, if it is anything, the temp is elevated. Whether that's usually r/t epidurals or dehydration (or both) is sometimes hard to call. About the only time we get lower than normal temps is coming from the OR. And we don't normally warm our fluids either.

I know this sounds rather obvious, but have your moms been drinking anything cold before you take their temp?

ischialspines · Jul 15, 2011

nope. although I've asked them each time out of shock, even though I've just been there and seen them push a baby out and know they've had nothing! I've re-checked ax and had it be about the same. While I'm new to the unit 3/4 moms I've recovered have all had these low temps. Maybe it's just a string of them, but if it's not, I might want some extra-extra blankets around before the baby pops out to keep the couplet skin to skin.

Elvish, BSN, DNP, RN, NP · Jul 15, 2011

Interesting.

I know when my daughter was born a few weeks ago and we were skin-to-skinning the nurse kept piling on the warm blankets, even though I didn't feel cold and my temp was fine. (DD's temp ended up being 100 axillary after an hour....think the warm blankets worked. LOL) Maybe she had recently had a string of cold moms too. Maybe some new epidural ingredient? I guess it can mess with your temp centers in more ways than one. You have me intrigued.

handyrn · Jul 15, 2011

Are you using dynamaps? I never trust those things. Are you using something digital to take the temps? Are you always using the same thermometer? Maybe it's as simple as that?

allnurses Guide · Jul 15, 2011

http://findarticles.com/p/articles/mi_m0689/is_n6_v36/ai_13993737/

Background. Epidural analgesia has been associated in previous research with an increase in maternal temperature.

Methods. Three studies were done: a retrospective chart review of women in labor, a prospective cohort study of women in labor, and a case-control study of newborns with fever. The prospective study enrolled 28 women, 14 of whom received epidural analgesia. Maternal temperature was measured hourly with a tympanic membrane thermometer. Other variables examined included duration of labor, duration of ruptured membranes, and room temperature. To further explore the possible association between maternal epidural exposure and newborn fever, a case-control study of newborns with fever at birth was carried out.

Results. In both the retrospective and prospective studies of women in labor, the duration of epidural analgesia was correlated with maximum maternal temperature during labor, with an increase, in the prospective study, of 0.07 [degrees] C per hour of exposure to epidural analgesia (P = .002). Controlling for other variables did not change the magnitude of this effect or its statistical significance. Similar trends were seen in the newborn's first temperature in both the prospective study of women in labor and the case-control study of newborns, but the associations were not significant (P = .07 and .08, respectively).

Conclusions. Epidural analgesia is associated with an increase in maternal temperature during labor and possibly with an elevation of newborn's first temperatures.

Elvish, BSN, DNP, RN, NP · Jul 15, 2011

The first epidural I got, my temp shot up to 103F, which won my son a ticket to all kinds of fun bloodwork after birth even though his temps were normal. Of course, I had also been ruptured almost 18 hours so I get that they were trying to cover their butts.

This last time around it didn't do anything, which I thought was interesting. Of course, I had it for about half as long the second time as the first.

ischialspines · Jul 15, 2011

Are you using dynamaps? I never trust those thing. Are you using something digital to take the temps? Are you always using the same thermometer? Maybe it's as simple as that?

We don't use dynamaps (that's the whole machine with BP and everything, yes?), we have a digital therm in every room so this is the same therm I have used since admission and through laboring (with normal temps). I am going to try and take temps more frequently than protocol during labor (q4h before ROM and q2h after ROM) to see if there's a trend (is it a drop right after the epi, after delivery from the pitocin bag, or a slow trend downward??). The low temps are in the immediate PP recovery hour. Their skin is cool to touch. I don't know if it's from the LR bolus pre epi, the epi dilation, proph pit after placenta delivery or just coincidental, but seems like it's normal to the other nurses. The ones that have had normal temps PP haven't had epidurals, but again I am new to hosp L&D and have never had such low temps during the first hour PP before!

ischialspines · Jul 15, 2011

http://findarticles.com/p/articles/mi_m0689/is_n6_v36/ai_13993737/
Background. Epidural analgesia has been associated in previous research with an increase in maternal temperature.

Yes, this is what I've always associated with epidurals as that's what the literature supports- which is why these low low PP temps are surprising to me!