Guide to Pyrexia In Pregnancy What The Doctor Prescribes
A complete plain-English guide to pyrexia (fever) in pregnancy: learn what causes it, when to seek help, safe medicines, and how doctors treat and prevent fever for you and your baby’s health.
Written by Dr. Siri Nallapu
Reviewed by Dr. Rohinipriyanka Pondugula MBBS
Last updated on 28th Oct, 2025
Introduction
Fever during pregnancy can be unsettling. Pyrexia—the medical term for fever—is usually a sign your body is fighting an infection. While many fevers are caused by mild illnesses, pyrexia in pregnancy deserves careful attention because even moderate temperature elevations can affect hydration, heart rate, and, in some situations, the developing baby.
The good news is that most fevers are treatable, and with prompt evaluation and the right plan, outcomes are excellent. This guide explains what doctors look for, what they typically prescribe, and how you can safely care for yourself at home.
Consult a Top General Practitioner for Personalised Advice
What Counts as Pyrexia in Pregnancy?
Understanding what qualifies as a fever helps you respond promptly and safely.
A fever is defined as a body temperature of 38.0°C (100.4°F) or higher. In pregnancy, that same threshold applies. Low-
grade temperature elevations (around 37.5–37.9°C or 99.5–100.3°F) may accompany mild illnesses but should still be
monitored closely if you feel unwell or are in early pregnancy.
Pregnancy changes your physiology—your blood volume rises, heart rate increases, and your immune system adapts—
sometimes masking infection symptoms. It’s also important to distinguish fever from hyperthermia, caused by external
heat (like saunas or hot tubs). Sustained high core temperatures early in pregnancy have been linked to an increased risk
of neural tube defects, so avoiding overheating and staying well hydrated are key.
Why Pyrexia Matters: Risks to Mother and Baby
Fever can affect both mother and baby, depending on timing, temperature, and underlying cause.
For the mother, fever raises heart rate and fluid needs, and if infection is present, it can progress to sepsis if untreated.
Maternal sepsis is a major cause of severe illness worldwide, but early recognition and antibiotics make outcomes much
better.
For the baby, risks vary:
- First trimester: Sustained high fever can slightly increase the risk of miscarriage or neural tube defects, but prompt
treatment and folic acid supplementation help reduce this. - Second and third trimester: Some infections causing fever, such as pyelonephritis or influenza, may trigger preterm labour or reduced amniotic fluid.
- During labour: Fever may indicate intra-amniotic infection (chorioamnionitis), prompting immediate antibiotics to protect mother and baby.
Common Causes of Pyrexia in Pregnancy
Identifying the cause is key to effective and safe treatment.
Respiratory Infections
Colds, influenza, COVID-19, and pneumonia are among the top causes of fever in pregnancy. Flu and COVID-19 can progress more severely, making early antiviral treatment vital.
Urinary Tract Infections (UTIs)
UTIs are common due to hormonal changes. Fever with flank pain or burning urination may indicate pyelonephritis, a
serious kidney infection requiring antibiotics.
Gastrointestinal or Food-borne Infections
Listeriosis from unpasteurised dairy or deli meats can cause fever and muscle aches. Prompt antibiotics are essential to
prevent complications.
Vector-borne Illnesses
If you’ve travelled to malaria or dengue areas, these infections should be considered. Both need specific management to
protect you and your baby.
Reproductive Tract Infections
Chorioamnionitis and postpartum endometritis cause fever with uterine tenderness and need urgent antibiotic treatment.
Non-Infectious Causes
Occasionally, fever stems from heat illness, autoimmune flares, or medication reactions.
When to Call the Doctor: Red Flags and Self-Triage
Knowing when to seek urgent care helps prevent complications.
Call your doctor or visit an emergency department if:
- Temperature is ≥38.5°C–39°C (101.3–102.2°F) or lasts more than 48 hours
- You experience shortness of breath, confusion, rash, or severe headache with neck stiffness
- You feel contractions, notice reduced fetal movements, or have foul-smelling discharge
- You have flank pain or blood in your urine
- You’ve recently eaten high-risk foods or travelled to areas with malaria or dengue
Mild fevers can be managed at home with fluids, rest, and paracetamol—but seek care if symptoms persist beyond 24–48 hours.
How Doctors Evaluate Pyrexia in Pregnancy
Your doctor will identify the cause through targeted questions, tests, and observations.
Typical assessments include:
- Blood tests: To check infection markers and rule out sepsis.
- Urine analysis: Detects UTIs or kidney infections.
- Respiratory tests: For flu, COVID-19, or strep throat.
- Travel-related tests: For malaria, dengue, or typhoid.
- Imaging: Chest X-ray (with shielding) or obstetric ultrasound to check mother and baby.
Digital platforms like Apollo 24|7 offer home collection for blood and urine tests, making diagnosis faster and safer.
What the Doctor Prescribes: Fever Reducers and Safety
Only certain medications are safe during pregnancy—knowing them protects you and your baby.
Paracetamol
This is the first-line treatment for fever in pregnancy. The typical dose is 500–650 mg every 6–8 hours, not exceeding
3,000 mg in 24 hours.
Avoiding NSAIDs
Ibuprofen and naproxen are generally avoided after 20 weeks of pregnancy because they can affect amniotic fluid and
the baby’s kidneys.
Non-Drug Measures
- Stay hydrated
- Rest in a cool environment
- Wear light clothing
- Avoid alcohol rubs or ice baths
If fever persists despite paracetamol and rest, consult a doctor online via Apollo24|7.
Targeted Treatments by Diagnosis
Treatment depends on the underlying infection and gestational stage.
UTIs and Pyelonephritis
Pregnancy-safe antibiotics include nitrofurantoin, amoxicillin-clavulanate, and cephalexin, depending on urine culture
results.
Influenza and Respiratory Infections
Oseltamivir is prescribed for flu, ideally within 48 hours of symptom onset.
COVID-19
Supportive care—fluids, rest, and paracetamol—is the mainstay. Some cases may need antivirals.
Listeriosis
Suspected cases are treated with ampicillin while awaiting confirmation.
Malaria and Dengue
Management is specialised—malaria may require artemisinin-based therapy, while dengue treatment is supportive.
Chorioamnionitis or Sepsis
Prompt IV antibiotics (e.g., ampicillin plus gentamicin) and fluid therapy are critical.
Prevention: Practical Steps to Reduce Pyrexia Risk
Simple preventive habits can significantly reduce infection risk during pregnancy.
Vaccinations
Ensure you receive the flu vaccine, COVID-19 boosters, and Tdap between 27–36 weeks.
Food Safety
Avoid unpasteurised milk, soft cheeses, and undercooked meats. Wash all produce thoroughly.
Travel and Vector Control
Use DEET-based repellents, protective clothing, and consult your doctor before travel to endemic regions.
Everyday Hygiene
Frequent handwashing, staying hydrated, and treating dental issues early help prevent infections.
Special Situations and FAQs Doctors Hear
Certain circumstances require extra caution and specialist input.
First-Trimester Fevers
Sustained high temperatures can affect early foetal development, but folic acid and timely fever control lower the risk.
Intrapartum and Postpartum Fever
Fever during or after labour often signals infection and requires antibiotics for mother and baby monitoring.
Chronic Conditions
Autoimmune disorders, thyroid problems, or kidney disease can make infections more likely and require coordinated care.
Conclusion
Pyrexia in pregnancy is common and usually manageable with early action. Most fevers come from treatable infections like colds or UTIs. The essentials are simple: monitor temperature, stay hydrated, take paracetamol safely, and seek help if symptoms worsen.
Preventive steps—such as vaccination, proper food hygiene, and prompt treatment—keep risks low. If your fever lasts beyond 24–48 hours, consult a doctor online with Apollo 24|7. For severe or persistent symptoms, book an in-person visit to ensure your and your baby’s safety.
Consult a Top General Practitioner for Personalised Advice
Consult a Top General Practitioner for Personalised Advice
Dr. Mainak Baksi
General Practitioner
13 Years • MBBS , MD (MPH)
Howrah
Mainak Baksi Clinic, Howrah
(50+ Patients)
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr Bhargav Vuppumalla
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD GENERAL MEDICINE
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Bimalbandhu Saha
General Physician/ Internal Medicine Specialist
40 Years • MBBS, DTM&H, Diploma in Maternity and Child Welfare
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
Dr. Asish Mondal
General Physician/ Internal Medicine Specialist
17 Years • MBBS, MD General Medicine
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Consult a Top General Practitioner for Personalised Advice
Dr. Mainak Baksi
General Practitioner
13 Years • MBBS , MD (MPH)
Howrah
Mainak Baksi Clinic, Howrah
(50+ Patients)
Dr. Rajib Ghose
General Physician/ Internal Medicine Specialist
25 Years • MBBS
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
Dr Bhargav Vuppumalla
General Physician/ Internal Medicine Specialist
5 Years • MBBS MD GENERAL MEDICINE
Bengaluru
Apollo Medical Center, Marathahalli, Bengaluru
Dr. Bimalbandhu Saha
General Physician/ Internal Medicine Specialist
40 Years • MBBS, DTM&H, Diploma in Maternity and Child Welfare
Kolkata
MCR SUPER SPECIALITY POLY CLINIC & PATHOLOGY, Kolkata
Dr. Asish Mondal
General Physician/ Internal Medicine Specialist
17 Years • MBBS, MD General Medicine
East Midnapore
VIVEKANANDA SEBA SADAN, East Midnapore
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Frequently Asked Questions
1) Is paracetamol safe during pregnancy for fever?
Yes, it is the first-line antipyretic when used correctly. If the fever lasts longer than two days, seek medical advice.
2) When should I worry about a fever during pregnancy?
Seek care for high or prolonged fever, breathing difficulty, rash, contractions, or reduced fetal movement.
3) What antibiotics are safe in pregnancy for a UTI with fever?
Nitrofurantoin, fosfomycin, amoxicillin-clavulanate, and cephalexin are commonly prescribed. Always follow the culture results.
4) Can I take ibuprofen for pyrexia in pregnancy?
Avoid ibuprofen, especially after 20 weeks, due to risks for the baby. Paracetamol is safer.
5) I ate soft cheese and now have a fever could it be Listeria?
It’s possible if it was unpasteurised. Contact your doctor promptly for blood tests and antibiotics if needed.