Fever during termination of pregnancy is an unreliable symptom of intrauterine infection

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  • Fever during second trimester termination of pregnancy associated with misoprostol and not intrauterine infection.

Why this matters

  • Fever has a low positive predictive value (PPV) for intrauterine infection in the setting of second trimester termination of pregnancy.
  • Fever is a adverse effect of misoprostol and not a sign of chorioamnionitis in these patients.
  • The use of antibiotics without other signs of infection is questionable.

Key results

  • 42% of participants developed fever.
  • Most developed fever within 10 h of start of procedure and disappeared after expulsion.
  • Women who developed fever were more likely to have a later gestation, be nulliparous, have a longer induction-expulsion time, and have used higher doses of misoprostol.
  • In patients with fever, 3% had evidence of infection by placental pathology.
  • In patients without fe...