Assessment of Maternal and Fetal Outcomes of Burn in Pregnancy

Abstract

Background: Burn injuries in pregnancy are often associated with a high rate of maternal and fetal mortality. They are considered relatively rare, but they affect the fate of the mother and the developing fetus. Aims and objectives: • To study the maternal and fetal outcomes in pregnant women with burns. • To evaluate the predictors of maternal and fetal mortality due to burns. Materials and methods: A retrospective study was conducted in the Department of Obstetrics and Gynaecology at Sri Aurobindo Institute of Medical Sciences and Postgraduate Institute, Indore (MP). The duration of this study was 2 years (March 2015 to February 2017). A total of 15 pregnant women with thermal injuries were included in this study. Data were obtained from the Medical Records Department of all the cases of burns during pregnancy, who were admitted into the hospital. The obtained data were analyzed regarding the age, duration of hospital stay, percentage of total body surface area (TBSA) burned, gestational age, and the maternal and fetal outcomes. Result: The mean age was 24.6 ± 5.26, median hospital stay 12.5 days, median gestational age 22.5 weeks, and burn size 59%. Eleven (73.4%) patients of accidental and four (26.6%) of suicidal cases were found. There were five (33.3%) cases in the 20–39% TBSA group, two (13.4%) cases in 40–59% TBSA, five (33.3%) cases in 60–79% TBSA, and three (20%) cases in >80% TBSA, respectively. There was a significant difference between fetal death and aliveness according to the first five (100%) and zero (0%), second five (83.4%) and one (16.6%), and third trimester one (25%) and three (75%), p = 0.001. The first trimester was associated with the highest incidence of fetal death. We found that TBSA (positive predictive value [PPV] = 0.607; p = 0.001) and trimester (PPV = 0.638; p = 0.001) were positive predictors for abortion/fetal deaths. Conclusion: The rate of fetal mortality was highest in the first and second trimesters. Maternal and fetal morbidity and mortality were directly proportional to TBSA.