A prospective analysis of hospital-acquired fever in obstetric and gynecologic patients

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Abstract
Of 2725 obstetric and 4090 gynecologic patients admitted to a community hospital during a 12-mo. period, 131 obstetric patients (4.8%) and 294 gynecologic patients (7.2%) had temperature elevations (rectal) of 38.3.degree. C or higher. All patients with fever were seen and followed up until discharge, and 80 different parameters were recorded for each patient, including sex, age, underlying illness, operative or diagnostic procedures, height and duration of fever, laboratory data, medications received and ultimate cause of fever. Obstetric patients (63, 48%) with temperature elevations were found to have infections and fever, with skin and soft-tissue infections (59%), urinary tract infections (16%) and bacteremias (10%) being most common. Febrile obstetric patients (68, 52%) were not found to have an infection. Gynecologic patients (86, 29%) with fever had an infection. Pelvic inflammatory disease (37%), urinary tract infection (18%), and abscess (14%) were the most common infections. Gynecologic patients (208, 71%) had fever, but the exact cause of the fever in these patients remains obscure. While fever cn be an early indicator of infection, it may be due to noninfectious causes in almost 2/3 of hospitalized obstetric-gynecologic patients.

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