Burns During Pregnancy

Abstract

A specific analysis of maternal-perinatal outcome based on TBSAB and gestational age is relevant to obstetric and emergency providers who provide care to pregnant burn patients.

Cesarean Delivery in the Management of Pregnancy Complicated by Burn Injuries

“…This strategy is categorically recommended by some authors for pregnancy management in the face of maternal burns exceeding 55% total body surface area 4 . Cesarean delivery is advocated to rescue viable infants who face hazard because of maternal burn injury and treatment; as well as to facilitate, for the mother, optimal fluid management, pulmonary function, intra-abdominal pressure management, and coagulopathy avoidance, all of which can be substantially complicated by pregnancy 8,13 …”

“…4 Cesarean delivery is advocated to rescue viable infants who face hazard because of maternal burn injury and treatment; as well as to facilitate, for the mother, optimal fluid management, pulmonary function, intra-abdominal pressure management, and coagulopathy avoidance, all of which can be substantially complicated by pregnancy. 8,13 The second case illustrates cesarean delivery as a reactive maneuver in the management of a pregnancy during a relatively minor burn. Early excision was performed in this case to optimize hand recovery.…”

“…Initial management included ventilatory support, fluid resuscitation (crystalloid and fresh-frozen plasma), antibiotics, and steroids for fetal pulmonary development support 7,8 …”

“…Initial management included ventilatory support, fluid resuscitation (crystalloid and fresh-frozen plasma), antibiotics, and steroids for fetal pulmonary development support. 7,8 At approximately 24 hours from injury, the patient was taken to surgery. A cesarean delivery was performed through the abdominal wall burn wound, with delivery of a viable male infant.…”

“…As late as the 1990s, cesarean delivery in the management of pregnancies complicated by burn injuries was mentioned mostly as a morbid, reluctantly chosen alternative to carefully monitored vaginal delivery 1–3 . Currently, however, cesarean delivery is promoted as a first-line element of management for pregnancies challenged by extensive burns, burn complications such as inhalation injury, fetal distress, and critical maternal care requirements 4–8 …”