Retrospective analysis of 35 burn patients in different stages of pregnancy

Abstract

Objective: To summarize the clinical outcomes of burn patients in different stages of pregnancy and explore a rational therapeutic scheme for burns during pregnancy. Methods: A retrospective observational study was conducted. From June 2010 to June 2020, 21 patients who met the inclusion criteria were admitted to the Department of Burns of Wuhan Third Hospital and 14 patients who met the inclusion criteria were admitted to the Department of Burns of the First Affiliated Hospital of Nanchang University. Based on the pregnancy period when patients suffered burns, the 35 patients were divided into early pregnancy group with 18 patients (aged (26±4) years, with 8 (4, 11) weeks of gestation), middle pregnancy group with 10 patients (aged (26±3) years, with 21 (14, 27) weeks of gestation), and late pregnancy group with 7 patients (aged (30±5) years, with 32 (29, 35) weeks of gestation). All the patients received treatment including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements. The burn-related complications during the treatment, maternal outcomes, fetal outcomes, fetal delivery mode, gestational weeks at delivery, and newborn weight of patients in the 3 groups were recorded. Data were statistically analyzed with one-way analysis of variance, Kruskal-Wallis test, and Fisher's exact probability test. Results: During the treatment, there were 4, 4, and 2 patients who suffered wound infections and 1, 3, and 2 patients who developed shock symptoms, respectively, in early pregnancy group, middle pregnancy group, and late pregnancy group. There were no statistically significant differences in them among the 3 groups (P>0.05). One patient in late pregnancy group developed into multiple organ dysfunction syndrome after debridement. At last, all the pregnant women survived, and no statistically significant difference existed among the 3 groups (P>0.05). In early pregnancy group, middle pregnancy group, and late pregnancy group, the survived fetus cases were 9, 8, and 6, respectively, and the differences between them were not statistically significant (P>0.05). Variables including stillbirth and full-term birth were close in patients in the 3 groups (P>0.05), while the preterm birth and miscarriage in patients in the 3 groups were statistically different (P<0.05 or P<0.01), with the early pregnancy group having the most miscarriage cases and the fewest preterm birth cases. There were no statistically significant differences in fetal delivery mode, gestational weeks at delivery, and newborn weight among the patients with survived fetus in 3 groups (P>0.05). Conclusions: For patients suffering burns during early, middle, and late pregnancy, superior rates of maternal and fetal survival can be achieved after timely and adequate treatments including fluid resuscitation, anti-infection, wound treatment, and multidisciplinary comprehensive managements.