Molecular Mechanisms of Epidural Related Maternal Fever

  • Research type

    Research Study

  • Full title

    EPIFEVER: Elucidating molecular mechanisms underlying epidural related maternal fever.



  • Contact name

    Gareth Ackland

  • Contact email

  • Sponsor organisation

    UCLH Joint Research Office

  • Research summary

    Approximately onethird
    of women in labour receive pain relief via an epidural. The epidural requires an anaesthetist to
    place a small plastic tube into a space in the back, through which local anaesthetic is infused. 25% of women who
    have an epidural suffer from a high temperature (known as epiduralrelated
    maternal fever (ERMF)), but the cause is
    unclear. Fever during labour can be a real problem, resulting in more stressful labour for mother and baby, potentially
    unnecessary treatment with antibiotics (for mother and baby) and more Caesarean section/forceps deliveries since
    obstetricians frequently suspect harm to the baby if the mother has fever.
    Local anaesthetics not only reduce pain, but may also damage immune cells resulting substances being released
    into the mother’s bloodstream causing fever. We will investigate whether the local anaesthetic causes fever through
    the release of feverinducing
    substances by undertaking tests on immune cells obtained from 2 groups of women:
    those receiving an epidural for pain relief and those who do not use epidural analgesia. We will also use samples
    from surgical patients who also receive epidural analgesia.
    We will insert an IV drip into women/patients which is used routinely as part of their hospital stay, thereby minimizing
    unnecessary discomfort. While inserting the IV drip a tablespoon of blood will be taken for laboratory tests. 4 hours
    later another tablespoon of blood will be taken. We will then compare function of immune cells before and after
    epidural local anaesthetic has been administered. If local anaesthetic is found to affect immune function and be a
    cause of fever, these results will enable us to identify the cause of fever in individual women in labour and help avoid
    unnecessary clinical interventions and antibiotic administration in the future

  • REC name

    South Central - Oxford A Research Ethics Committee

  • REC reference


  • Date of REC Opinion

    18 Aug 2014

  • REC opinion

    Further Information Favourable Opinion