Burn and Pregnancy

Abstract

Burns in pregnant women, although rare, can be serious, and therefore can be life-threatening for the mother and fetus. Morbidity and mortality are influenced by factors related to the burn, such as the depth and the TBSA burned, and patient-related factors, such as age, pre-existing medical conditions, associated injuries, and the term of the pregnancy. The fetal prognosis is generally good when the mother does not develop severe complications such as sepsis, hypotension, or hypoxia. The management’s goal is maternal and fetal rescue. The treatment protocol must be well codified, requiring the establishment of a multidisciplinary team involving plastic surgeons, reanimators, and obstetricians. Treatment including aggressive hydro-electrolyte resuscitation, oxygen therapy, thromboprophylaxis, and early and effective antibiotic prophylaxis, are effective measures for both maternal and fetal management. Early excision of deep lesions and skin grafts is the cornerstone of the management of burnt pregnant women, in order to reduce the amount of prostaglandin and cytokines released into the circulation. As part of the fetal rescue, labor induction is imperative if pregnancy is in the third trimester for extraction from the toxic environment, otherwise, tocolysis and obstetrical monitoring to reach the third trimester. We present a case series of burns occurring in pregnant women treated at the National Center for Burns and Plastic and Restorative Surgery.