Maternal intra-partum fever commonly complicates the process of labour. Its occurrence is often regarded as being synonymous with the presence of chorioamnionitis. This inevitably results in the administration of antibiotics to the affected mother. Review of the literature however suggests that this approach is not always appropriate. Non-infective causes of this condition that are often overlooked include the use of epidural analgesia for pain relief, normal thermal physiological changes in women not using any form of analgesia and delivery in an overheated room. Women with certain risk factors such as nulliparity and a long latent phase of labour are also more prone to developing maternal intra-partum fever. Irrespective of its aetiology, maternal intra-partum fever carries risks both for the mother and her unborn child. Putting more thought into the care of these patients will go a long way in reducing the maternal and neonatal morbidity associated with this complication.

We conducted a case-controlled retrospective cohort study of all pregnancies achieved with the help of assisted reproductive technology (ART) in the Assisted Conception Unit of the Royal Shrewsbury Hospital between September 1999 and March 2004 to assess if our experience was comparable with that reported in other studies. A total of 176 women with similar pregnancies were studied, half of which were conceived with ART and the other half were spontaneous pregnancies in fertile women. Continuous variables were compared by means of the paired t-test and categorical variables by means of the McNemar's test. Women who conceived with ART did not appear to be at greater risk of developing pre-eclampsia (OR 0.8, 95% CI 0.2-2.9), PPROM (OR 0, CI 0-5.3,) abruptio placentae (OR 0, CI 0-1.5) or placenta praevia (OR 0, CI 0-39). They were, however, more likely to require caesarean delivery (OR 2, CI 0.7-5.8). Our ART women did not have an excess of obstetric complications when compared with their controls who conceived spontaneously. They however, had a tendency to a higher caesarean section rate.

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Review of the first 1502 cases of ECG-ST waveform analysis during labour in a teaching hospital Sir, I read with interest the article by Doria et al. 1 on their experience of using the cardiotocography (CTG)-ST waveform 922