[Severe burns in Pregnant Women: Incidence and Factors Associated with Mortality].

Abstract

Burn injury that occurs in pregnancy is considered severe when it affects the functional and/or vital prognosis. The aim of our study was to describe the incidence, the epidemiological, clinical characteristics, and factors associated with mortality of severe burns in pregnant women. A retrospective descriptive study was conducted in the burn intensive care department in Tunisia over a period of 16 years. All burned pregnant women requiring intensive care hospitalization for severe burns were included. Twenty-six pregnant women were included (7.5%). The average age was 28±5 years old. Burns were secondary to a domestic accident in 19 cases and a suicide attempt in 5 cases. Burns were thermal in all cases, caused by flames in 22 cases, occurring at home in 85% of cases (n=22), and occurred mainly in the second and third trimester (n=2). The average total body surface area was 32%±24%. Most patients were transferred from another hospital (n=22, 85%). Eight patients were initially in a hypovolemic shock, and nine patients were under mechanical ventilation. There have been eight fetal deaths (31%), and eight maternal deaths (31%). Total body surface area, prognosis scores, immolation, hypovolemic shock on admission, pulmonary injuries, acute kidney injury, sepsis and acute respiratory distress syndrome were the associated mortality factors. Burns in pregnant women is a rare but serious injury since it affects the fetal and maternal prognosis. Early management in a specialized structure could improve prognosis.