Obstetric Implications of Burns in Pregnancy

Abstract

Reports on burns in pregnancy in the world literature are scarce. The present authors have collected details of 50 patients with burns in pregnancy of sufficient severity to warrant hospital admission. The results relevant to, and the implications for, obstetrical practice are presented and discussed in this paper.

The 50 patients were divided into two groups. One group was composed of 23 women who were discharged from the hospital while still pregnant, and the second group comprised the other 27 women whose pregnancies ended during admission for primary burn care. Only three women discharged while still pregnant had severe burns (40 per cent or more), all occurring in the first trimester. Both fetus and mother survived in each of these cases, and it seems possible that the pregnancy is less vulnerable in the first trimester. Where the pregnancy ended prematurely, it is clear that a burn of 50 per cent forms the watershed of maternal survival (an important factor in management). Only two of the 13 patients with burns of less than 50 per cent died, both being near term in the third trimester and suffering irreversible cardiores-piratory arrests in the first 24 hours. Thus patients in the third trimester who may be approaching the physiological limits of cardiovascular homeostasis require particularly careful resuscitation.