Molecular Mechanisms of Epidural Related Maternal Fever

• Research type

  Research Study

• Full title

  EPIFEVER: Elucidating molecular mechanisms underlying epidural related maternal fever.

• IRAS ID

  138455

• Contact name

  Gareth Ackland

• Contact email

  g.ackland@ucl.ac.uk

• 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

  14/SC/1160

• Date of REC Opinion

  18 Aug 2014

• REC opinion

  Further Information Favourable Opinion