Maternal and Fetal Outcome in Second and Third Trimesters of Pregnancy with Burn

Abstract

Introduction: Burns in pregnancy is common in Bangladesh. Burns are a major, global public health problem, resulting in an estimated 195,000 deaths annually. The majority of burns occur in low-and middle-income countries, with almost half occurring in the World Health Organization (WHO) South-East Asia Region. Objective: To assess the maternal and fetal outcome in second and third trimesters of pregnancy with burn. Methods: This is a retrospective study was conducted in Burn and plastic surgery unit Dhaka Medical College Hospital, Dhaka, Bangladesh from March to May 2022. Total 28 patients admitted were included. The data was collected on the basis of age, percentage of burn over the body surface, gestational age, maternal and foetal outcome. All admitted patients having burn with live pregnancy was included in the study and epidermal burn and burn with other severe co-morbidities were excluded from the study group. All patients were informed about the study. Then those patients willing to take part in the study were included. Results: Total 28 patients (3.1% of female burn patient of childbearing age), having burn with Pregnancy were included in this study fulfilling the inclusion and exclusion criteria. Among 28 patients, 10 (35.7%) patients were in age group 15-20 years followed by 11 (39.3%) in age group 21-25 years, 5 (17.8%) in age group 26-30 and 1 (3.6%) patient each was in age group 31-35 years and 41-45 years group. Age range was 16-45years. 96.4% burn Accidental and 3.6% burn Suicidal. Among 28 patients, 16 (57.1%) were survived after treatment and 12 (42.9%) patients died. The causes of death were septicemia and MODS in maximum cases. Fetal outcome shows, 16(57.1%) fetus were survived. Of them 8 pregnancy continued till discharge, 8 babies were delivered during treatment period (6 by normal vaginal delivery, 2 by caesarian section). 12 (42.9%) fetal death occurred. Among them 5 fetus died with maternal death, 1 intrauterine death follower by normal delivery and 1 still birth occurred. Conclusion: Most burns with pregnancy are in the 16-30 years age group and accident was the major cause of injury. Inhalation injury, burn related complications like burn shock, septicemia and infection are major factors responsible for maternal and fetal mortality. Early hospitalization, prompt and aggressive fluid management, proper management of suspected inhalation injury and early identification and management.