Demam pada Penggunaan Analgesia Persalinan Epidural

  • Alfan Mahdi Nugroho
  • Yusmein Uyun Faculty of Medicine Universitas Gadjah Mada Yogyakarta
  • Annemarie Chrysantia Melati Faculty of Medicine Universitas Gadjah Mada Yogyakarta
Keywords: analgesia epidural, demam, persalinan, epidural analgesia;, fever, labour

Abstract

Analgesia epidural telah diperkenalkan secara rutin sebagai salah satu modalitas analgesia pada proses persalinan sejak lama. Hubungan antara analgesia epidural persalinan dengan demam intrapartum pada maternal sudah disebutkan pada beberapa literatur. Demam didefinisikan sebagai peningkatan suhu tubuh lebih dari 38 oC yang didapat dari dua kali pemeriksaan. Beberapa teori yang disebutkan antara lain perubahan termoregulasi, infeksi pada ibu-janin dan inflamasi non-infeksi yang dimediasi oleh sitokin proinflamasi. Namun demikian berbagai mekanisme analgesia epidural dapat menyebabkan demam masih terus diteliti. Identifikasi demam pada ibu saat persalinan merupakan hal yang penting untuk dilakukan karena memiliki konsekuensi klinis pada ibu dan neonatus. Pada ibu ditemukan suhu yang meningkat dikaitkan dengan peningkatan denyut jantung ibu, curah jantung, konsumsi oksigen, dan produksi katekolamin. Sedangkan pada janin demam intrapartum dapat menyebabkan sepsis, perubahan skor APGAR, peningkatan kebutuhan bantuan napas dan kejadian kejang. Efek demam pada ibu dan janin masih terus dipelajari, sehingga suatu saat didapatkan cara pencegahan yang paling baik yang pada akhirnya menghindarkan keraguan untuk melakukan analgesia persalinan.

 

Fever during labour epidural analgesia

Abstract

Epidural analgesia has been routinely introduced as one of the analgesia modalities during labour. Literature has mentioned the relationship between epidural analgesia and intrapartum fever among mothers. Fever is defined as increased temperature above 38 oC in more than two measurements. Several theories have been proposed, inculing thermoregulation changes, mother-fetal infection, and non-infectious inflammation mediated by proinflammatory cytokines. However, these mechanisms have been continued to evolve. Fever identification in pregnant women is essential to recognize clinical consequences to both mothers and neonates. Increased temperature in mothers is associated with increased heart rate, cardiac output, oxygen consumption, and catecholamines production. Meanwhile, in neonates intrapartum fever is related to sepsis, APGAR score changes, the need of respiratory support and incidence of neonatal seizure. Therefore, these consequences are extensively studied in order to determine the appropriate prevention.

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Author Biographies

Yusmein Uyun, Faculty of Medicine Universitas Gadjah Mada Yogyakarta

Departement of Anesthesiology and Intensive Care Dr. Sardjito General Hospital Yogyakarta 

Annemarie Chrysantia Melati, Faculty of Medicine Universitas Gadjah Mada Yogyakarta

Department of Anesthesiology and Intensive Care Dr. Sardjito General Hospital Yogyakarta

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CROSSMARK
Published
2020-04-14
DIMENSIONS
Section
Literature Review

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