Maternal and Fetal Outcome of Burn with Pregnancy: A Prospective Observational Study at a Tertiary Burn Hospital
Author(s): Sayeqa Nasreen Khondker, S M Mohiuddin, Rayhana Awwal
Background
Burns with pregnancy is a potentially life-threatening scenario as it may lead to rapid depletion of the already diminished maternal reserves and have adverse effects on maternal and fetal outcome. Limited studies and controversy between results of different studies needs more studies to be performed to clearly define the protocols that should be followed when a pregnant woman is admitted in a hospital with burns.
Materials and methods
A prospective type of observational study was carried out on 30 burn patients with pregnancy admitted in Department of Plastic Surgery and Burn Unit, Dhaka Medical College Hospital, Dhaka for a period of 12 (twelve) months to find out maternal & fetal outcome and to determine factors influencing outcome. All patients were managed using standard burn management protocol in consultation with obstetrician. Regular monitoring was done and the outcome was recorded.
Result
Mean TBSA burn was 26.23 ± 13.93 %. 17 (56.7%) patients went back home alive and 13 (43.3%) died. 17(56.7%) fetus survived but 13 (43.3%) fetal death occurred. Maternal and fetal mortality was proportional to the TBSA burn. Maternal and fetal death in patients with burn shock and inhalation injury was 100% and 75% respectively. Death were due to septicemia [n=6(20.0%)], MODS [n=5(16.7%)], ARDS [n=1(3.3%)] and DCM [n=1(3.3%)]. Mean period of wound healing was 30.64 ± 14.02 days and the mean duration of hospital stay was 22.60 ± 18.26 days.
Conclusion
Early Hospitalization, prompt and aggressive fluid management, proper management of suspected inhalation injury and early identification and management of infection and sepsis by appropriate antibiotic which are safe for fetus can reduce both maternal and fetal death. Best care is possible using a multidisciplinary team approach with active participatio