Burns and pregnancy

Pregnancy does not predispose to thermal injuries. Most burns are minor, and erythema usually subsides within 24 hours during the outpatient therapy. Severe burns during pregnancy are rare but alarming events. Care should be provided at a regional facility with expert burn care and fetal monitoring. Attempts should be undertaken during maternal transport to avoid hypovolemia, hypotension, and hypoxia. The wound should be covered with sterile dressings to prevent further contamination. Maternal and fetal survival is directly related to the extent of the body surface injury. When maternal injury is lethal, fetal survival is very unlikely because of sudden in-utero death or complications from prematurity following spontaneous labor. Complications to be considered during the emergent and acute phases of recovery include fluid and electrolyte imbalance, respiratory difficulties, systemic and wound infection, inadequate nutrition, and emotional disturbances. Therapy should be directed to saving the mother. Whether fetal well being is compromised by the burn and resultant therapy is difficult to determine from prior published reports. Periodic ultrasonic examination and biophysical testing of the fetus are recommended. If conditions are considered unfavorable to meet fetal circulatory and oxygen demands, prompt delivery during the late second and third trimesters has been advocated if the mother's burn covers 50 per cent or more of the surface area. If the patient has instead recovered satisfactorily and there has been no evidence of fetal jeopardy or premature labor within the first week following the burn injury, the eventual delivery of a healthy-appearing, term-sized fetus is quite likely.