Thermal injury in the pregnant patient

Thermal injury sustained during pregnancy presents special management problems for both the gravid woman and her unborn child. Of 6,573 admissions to this burn center during the period of 1950 through 1982, 1,157 (17.6 per cent) were female and 448 (6.8 per cent) were of reproductive age. Thirty of this latter group (6.7 per cent) of burned patients were pregnant at the time of injury. These 30 patients ranged in age from 16 to 37 years old (an average of 22.7 years) and the burned portion of the total body surface area ranged from 6 to 92 per cent (an average of 39.7 per cent). A review of the clinical courses of these 30 patients suggests several observations and conclusions. Pregnancy does not alter the maternal outcome after thermal injury and maternal survival is usually accompanied by fetal survival in the absence of significant complications. If the injury of the gravid patient is lethal, the pregnancy will usually terminate spontaneously prior to her death. Obstetric support and aggressive fetal monitoring is recommended for all moderately and severely burned pregnant patients. Obstetric intervention may be considered in the ill patient with a near term fetus in whom significant complications (such as, hypotension, hypoxemia or sepsis) jeopardize the life of the fetus.