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Pregnant. Suffering from fever, cold and upper abdominal pain. Using dolo 650mg. What to do?

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hi,, i'm having fever from yesterday night. temperature is 101 - 102. i'm 6months pregnant. so can you help me in getting normal. FROM FEW HOURS I'M GETTING LITTLE UPPER ABDOMEN PAIN. I'M FEELING COLD. I'M USING DOLO 650 MG FROM YESTERDAY NIGHT. I USED IT THRICE TILL NOW BUT THERE'S NO RESULT..
Posted Sat, 10 Nov 2012 in Women's Health
Answered by Dr. Asra Ishtiaq Ahmed 1 hour later
Hello there.

Thanks for writing to us.

Any fever in pregnancy should be taken care of at once. DOLO is PARACETAMOL and is safe in pregnancy. It would help you in bringing down your temperature but has no role in treating the cause of fever. You will keep having repeated high grade fever if the cause is not treated.

A temperature rise above 101F (38.30C) may be worrying. Also body temperature above 102F (38.90C) for an extended period of time could become problematic.
This is because high fever is toxic to fetus and can lead to abortion and intrauterine death (death of baby inside uterus). So its important to bring down temperature with Paracetamol as well as to remove the cause of fever.

Causes of fever are many, some of which are:
1. Upper respiratory infections(URTI)- If you have running nose, sore throat, cough, and fever, URTI can be a possibility. Usually it is due to viral infection, but if superimposed bacterial infection occurs, you will have yellow sputum with high grade fever. In that case you need to start antibiotics.

2. symptoms , you need to get a urine microscopy and culture test done along with ultrasound abdomen to rule out pyelonephritis (involvement of kidneys).

3. Malaria can also present with high grade fever, chills, headache, abdominal pain, lethargy, fatigue and vomiting. To rule out this as a possibility, complete blood count with MPFT (MALARIAL PARASITE AND FILARIAL TEST) should be done when you have a fever spike.

4. Typhoid can be another possibilty if you have loose stools with high fever, abdominal pain, decreased appetite and fatigue. Blood culture can rule out typhoid.

5. Gastrointestinal infections can present with loose stools with mucus or blood, fever, nausea, vomiting, abdominal cramps. Stool microscopy and ova test helps in excluding these.

6. Chorioamnionitis is a bacterial infection of the amniotic fluid which surrounds the baby. Along with fever, there may be abdominal pain accompanied by uterine (abdominal)tenderness and contractions. A foul-smelling amniotic fluid or vaginal discharge may be present. If chorioamnionitis is diagnosed, the baby has to be delivered immediately, no matter what the gestational age, to avoid risk of a neonatal infection.

7. Other cause could be appendicitis which presents with vomiting, fever, abdominal pain which is initially generalized and later localized to umblicus (navel button).

8. Hepatitis infection can also present with fever in pregnancy. Screening of hepatitis B along with HIV is routinely done in pregnancy. If you have not got these tests done, then do get it done.

You should know warning signs of fever in pregnancy which include abdominal pain,
uterine tenderness, uterine contractions, nausea ,vomiting,diarrhea and skin rash. In case you have any of these, you should see a gynecologist personally especially if the fever has persisted for more than 24 hours.

Cause of fever has to be determined and medication should be taken only after consultation. All drugs are not safe for use during pregnancy. So I suggest you to XXXXXXX a gynecologist personally. Meanwhile you should drink plenty of fluids to avoid dehydration. Take adequate rest and enough sleep. Wear loose, comfortable clothes and stay in a cool environment.
Do get an ultrasound for the well being of your baby once you recover.

Wishing you a speedy recovery.

If you have any further queries, you are most welcome to ask.

Take care.
Above answer was peer-reviewed by
Follow-up: Pregnant. Suffering from fever, cold and upper abdominal pain. Using dolo 650mg. What to do? 22 hours later
I have taken a blood test and a urine test and everything seemed fine except the RBC count which is about 5.32 million which the doctor said is fine and happens because of the fever.Though i was running a high fever yesterday of about 102 which didnt decrease even though i was using dolo 650.Today i had a temperature of 99 all day and had rigors(teeth chattering,body shaking for about 20 mins) a couple of times when i had to use a hot water bag for them to it malaria because i heard malaria cannot be seen in the blood till after a couple of days.I am using a anti biotic called Taxim 200.Will my baby be fine?will she be affected by any of this?And is the antibiotic too strong for my baby?I am 24 weeks pregnant.Thanks in advance!
Answered by Dr. Asra Ishtiaq Ahmed 4 hours later
Hello there.

Thanks for writing back.

Its good to know that your blood and urine reports were normal. The RBC count you have mentioned is normal and nothing to worry about.
Its good to know that you are keeping a record of your temperature.
Taxim belongs to cephalosporin group of antibiotics and is safe in pregnancy. It is a broad spectrum antibiotic and covers bacterial infections.
Your doctor must have examined you physically to rule out foci of infection and after evaluating everything she would have given this antibiotic.
You can continue with this and need not worry about the dose. It is given in this dose only and is effective only then. It wont cause any harm to your baby.
Chills in fever are expected with bacterial infections and also in malaria.
You are right that malarial parasite cannot be always detected on blood films. The probability increases when blood film is tested at the spike of fever. Other tests which help in ruling out malaria is QBC which is fluorescence microscopy based malaria diagnostic test that speeds and simplifies malaria detection. But I presume your doctor would have ruled out the possibility of malaria as splenomegaly (enlargement of spleen ) can be detected on physical examination and generally seen in malaria.
I suggest you keep continuing taxim. This because your fever spike has reduced and you have recorded only 99 degrees after starting taxim which means its effective in clearing the foci of infection you have which is causing fever.
You have to continue it for minimum 7 days to have complete response. If after 48 hours of use of taxim, you do not get afebrile (fever free) then you should visit your doctor. If you continue having spikes of fever, malaria can be a possibility as taxim is not effective for malaria.
Meanwhile keep a good diet with good fluid intake to avoid dehydration. Take adequate rest . Also keep a record of your baby movements which should be atleast 10 per day or 3 after every meal. In case they become less, do see your doctor immediately. After you recover, get an ultrasound done to assess the well being of your baby.

Wishing you speedy recovery.
Take care.
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