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Third Degree Burns in Pregnancy (part I)

Anyone is susceptable for burn injuries including pregnant women. The incidence of burns during pregnancy is higher in developing countries compared to developed countries. Most of the burns happening in pregnant women are accidental and are caused by different causes. The most common causes are scalding followed by flame injury. Other causes my include chemical, flash, electrical and friction burns.

The management of burns in pregnant women is not easy, it requires a multidisciplinary approch with close monitoring of fetal and maternal well being. For the mother the aim of the treatment is to restore full range of function and to minimize damages as much as possible. For the fetus the aim of treatment is reach full term being healthy without any congenital abnormalities. Treatment is more difficult in the first trimester of pregnancy because of thr risk of abortion. When the mother is at or near term, delivery should be done as soon as possible.

Minor burns may have no effect on the course of pregnancy but burns of at least 35% of total body surface area can induce early delivery and/or fetal loss. When a burn injury happen in a pregnant lady and depending on the severity of the burn there will be multiple body reactions among which are the following:

  • An increase in the capillary permeability leading to the leak of fluid from the vesseles to the outside resulting in a decrease in the mother’s fluid volume (hypovolemia) that in turn will lead to a reduction in the uterine blood flow, amniotic fluid and placental blood supply leading to placental insufficiency, fetal hypoxia (decrease oxygen) and ischemia. Leaking of fluid from the capillaries will also lead to a decrease in the mother’s blood pressure (hypotension) if she is inadequately resuscitated.
  • As a result of the mother’s smoke inhalation and chemical irritation to the airway, the maternal oxygen saturation will decrease leading in turn to a decrease in the fetal oxygen saturation (hypoxia).
  • Overwhelming maternal systemic infection leading to maternal septic shock that wil lead to fetal hypoxia and acidosis.
  • The release of enzymes and inflammatory mediators that stimulate uterine contractions

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Some or all of these reactions may lead to Spontaneous uterine contractions that lead to abortion or premature delivery after intrauterine death of the featus.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

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