[Burns and pregnancy. A case of severe burn occurring at the beginning of pregnancy. Maternal and fetal survival]

Abstract

The authors report a case of a severe thermal burn (70% of the surface of the body) in a pregnant woman who had 15 weeks amenorrhoea. The survival of the mother and the continuation of the pregnancy to term allowed a normal live baby to be born. As far as the authors know this is the fourth case history of a severe (more than 60% of the body) burn published occurring in the first trimester of pregnancy and carried through successfully to term. A study of the literature has shown that the physiopathological results of severe burns do explain the usually poor prognosis for mother and fetus. Large quantities of prostaglandins are released into the circulation of the mother because of the thermal insult to tissues and because of the infection that usually accompanies such burns. These prostaglandins can stimulate the myometrium, which gives rise to fatal obstetric complications. The urgent acute treatment for a severe burn in a pregnant woman, which should preferably be carried out in a special centre, consists in water and electrolyte resuscitation, assisted respiration and prevention of bacterial contamination. These measures are just as important for the fetus. At the same time obstetric care should be started. Good collaboration between the obstetricians and those who carry out the resuscitation all bring about the measures that are needed to allow the mother and fetus to survive.