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

J. J. Klimek, E. R. Ajemian, J. Gracewski, B. Klemas and R. Quintiliani

Of 2,725 obstetric and 4,090 gynecologic patients admitted to a community hospital during a 12-month period, 131 obstetric patients (4.8%) and 294 gynecologic patients (7.2%) had temperature elevations (rectal) of 38.3 degrees 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. Sixty-three obstetric patients (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. Sixty-eight febrile obstetric patients (52%) were not found to have an infection. Eighty-six gynecologic patients (29%) with fever had an infection. Pelvic inflammatory disease (37%), urinary tract infection (18%), and abscess (14%) were the most common infections. Two hundred eight gynecologic patients (71%) had fever, but the exact cause of the fever in these patients remains obscure. While fever can be an early indicator of infection, it may be due to noninfectious causes in almost two thirds of hospitalized obstetric-gynecologic patients.