Retrospective analysis of 35 burn patients in different stages of pregnancy

Zhou Jinxiu; Guo Guanghua; Yu Gang; Hong Huili; Xie Weiguo; Liu Shuhua

doi:10.3760/cma.j.cn501225-20220214-00027

Volume 38 Issue 5

May 2022

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Article Navigation > CHINESE JOURNAL OF BURNS AND WOUNDS > 2022 > 38(5): 415-421

Zhou JX,Guo GH,Yu G,et al.Retrospective analysis of 35 burn patients in different stages of pregnancy[J].Chin J Burns Wounds,2022,38(5):415-421.DOI: 10.3760/cma.j.cn501225-20220214-00027.

Citation:

Zhou JX,Guo GH,Yu G,et al.Retrospective analysis of 35 burn patients in different stages of pregnancy[J].Chin J Burns Wounds,2022,38(5):415-421.DOI: 10.3760/cma.j.cn501225-20220214-00027.

Citation:

Zhou JX,Guo GH,Yu G,et al.Retrospective analysis of 35 burn patients in different stages of pregnancy[J].Chin J Burns Wounds,2022,38(5):415-421.DOI: 10.3760/cma.j.cn501225-20220214-00027.

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Retrospective analysis of 35 burn patients in different stages of pregnancy

doi: 10.3760/cma.j.cn501225-20220214-00027

1.
Department of Burns, Tongren Hospital of Wuhan University＆Wuhan Third Hospital, Wuhan 430060, China
2.
Department of Burns, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
3.
Department of Obstetrics, Tongren Hospital of Wuhan University＆Wuhan Third Hospital, Wuhan 430060, China

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Corresponding author: Liu Shuhua, Email: liushuhua32@hotmail.com
Received Date: 2022-02-14

Abstract

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.
- Burns,
- Pregnancy,
- Diagnosis,
- Therapeutic uses

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References

[1]	KarimiH, Sedigh-MaroufiS, AkbariH, et al. Pregnancy and burns: guidelines for safe management[J]. Burns, 2020, 46(7): 1620-1631. DOI: 10.1016/j.burns.2020.04.005.
[2]	ShiY, ZhangX, HuangBG, et al. Severe burn injury in late pregnancy: a case report and literature review[J/OL]. Burns Trauma, 2015, 3: 2[2022-02-14].https://pubmed.ncbi.nlm.nih.gov/27574648/. DOI: 10.1186/s41038-015-0002-z.
[3]	Correia-SáI, MarquesM, HortaR, et al. Experience in management of burn injury during pregnancy in a burn unit[J]. J Burn Care Res, 2021, 42(2): 232-235. DOI: 10.1093/jbcr/iraa141.
[4]	MaghsoudiH, SamniaR, GaradaghiA, et al. Burns in pregnancy[J]. Burns, 2006, 32(2): 246-250. DOI: 10.1016/j.burns.2005.10.003.
[5]	NnadozieUU, MadubaCC, OkorieGM, et al. Burns in pregnancy: five-year experience in a tertiary hospital in southeastern Nigeria[J]. Malawi Med J, 2021, 33(3): 204-209. DOI: 10.4314/mmj.v33i3.8.
[6]	任霞, 张艳梅, 陈忠. 妊娠期烧伤护理与治疗[J/CD]. 中华损伤与修复杂志:电子版, 2014, 9(6): 685-687. DOI: 10.3877/cma.j.issn.1673-9450.2014.06.024.
[7]	薛迪建, 陈炯, 黄文祥, 等. 妊娠晚期特重度烧伤并发死胎及多器官功能障碍综合征一例[J]. 中华烧伤杂志, 2020, 36(7): 607-609. DOI: 10.3760/cma.j.cn501120-20190416-00192.
[8]	赵颖, 初静. 1例妊娠32周突发大面积烧伤患者急诊行剖宫产的护理[J]. 中华急危重症护理杂志, 2020, 1(3): 284-285. DOI: 10.3761/j.issn.2096-7446.2020.03.022.
[9]	周晓萍, 黄锐文, 钟燕, 等. 1例妊娠晚期特重度烧伤并吸入性损伤患者的护理[J]. 吉林医学, 2014, 35(1): 217-218.
[10]	沈金飞, 胡梦雪, 严晓鸥. 妊娠晚期大面积烧伤1例护理[J]. 上海护理, 2018, 18(1): 67-69. DOI: 10.3969/j.issn.1009-8399.2018.01.022.
[11]	徐丽南, 王子莲, 张颖, 等. 妊娠合并烧伤20例诊治分析[J/CD]. 中华产科急救电子杂志, 2012, 1(1): 47-49. DOI: 10.3877/cma.j.issn.2095-3259.2012.01.011.
[12]	杨雪梅, 孙丽芳. 妊娠合并烧伤13例的临床护理[J]. 中国误诊学杂志, 2010, 10(14): 3474.
[13]	王国安, 陈素茹, 刘凌风. 妊娠合并烧伤78例治疗分析[J]. 武警医学院学报, 2006, 15(2): 137-138. DOI: 10.3969/j.issn.1008-5041.2006.02.019.
[14]	KennedyBB, BairdSM, TroianoNH. Burn injuries and pregnancy[J]. J Perinat Neonatal Nurs, 2008, 22(1): 21-30; quiz 31-32.DOI: 10.1097/01.JPN.0000311871.46075.3d.
[15]	VaghardoostR, KazemzadehJ, RabieepoorS. Epidemiology of burns during pregnancy in Tehran, Iran[J]. Burns, 2016, 42(3): 663-667. DOI: 10.1016/j.burns.2015.10.001.
[16]	姚明, 吴银生, 陆安民. 妊娠合并烧伤的临床分析(附7例报告)[J]. 中国医师杂志, 2005, 7(8): 1098-1099. DOI: 10.3760/cma.j.issn.1008-1372.2005.08.054.
[17]	蔡玉娥. 治愈重度烧伤合并重度妊娠高血压综合征一例[J]. 中华烧伤杂志, 2002, 18(2): 121. DOI: 10.3760/cma.j.issn.1009-2587.2002.02.033.
[18]	ParikhP, SunesaraI, LutzE, et al. Burns during pregnancy: implications for maternal-perinatal providers and guidelines for practice[J]. Obstet Gynecol Surv, 2015, 70(10): 633-643. DOI: 10.1097/OGX.0000000000000219.
[19]	MagoV, AhmadI, KochharN, et al. Burnt pregnant wives: a social stigma[J]. Burns, 2005, 31(2): 175-177.DOI: 10.1016/j.burns.2004.07.005.
[20]	RezavandN, SeyedzadehA. Maternal and foetal outcome of burns during pregnancy in Kermanshah, Iran[J]. Ann Burns Fire Disasters, 2006, 19(4): 174-176.
[21]	LoMauroA, AlivertiA, FrykholmP, et al. Adaptation of lung, chest wall, and respiratory muscles during pregnancy: preparing for birth[J]. J Appl Physiol (1985), 2019, 127(6): 1640-1650. DOI: 10.1152/japplphysiol.00035.2019.
[22]	MaaroufR, CampbellC. Acute respiratory failure and burn patient outcomes[J]. Curr Opin Anaesthesiol, 2021, 34(2): 180- 186. DOI: 10.1097/ACO.0000000000000973.
[23]	FoncerradaG, CulnanDM, CapekKD, et al. Inhalation injury in the burned patient[J]. Ann Plast Surg, 2018, 80(3 Suppl 2): S98-105. DOI: 10.1097/SAP.0000000000001377.
[24]	DucasR, SainiBS, YamamuraK, et al. Maternal and fetal hemodynamic adaptations to pregnancy and clinical outcomes in maternal cardiac disease[J]. Can J Cardiol, 2021, 37(12): 1942-1950. DOI: 10.1016/j.cjca.2021.06.015.
[25]	HarvilleEW, CrookCE, BazzanoLA, et al. Cardiovascular risk factors before and during pregnancy: does pregnancy unmask or initiate risk?[J]. J Obstet Gynaecol Res, 2021, 47(11): 3849- 3856. DOI: 10.1111/jog.14971.
[26]	WilliamsFN, HerndonDN. Metabolic and endocrine considerations after burn injury[J]. Clin Plast Surg, 2017, 44(3): 541-553. DOI: 10.1016/j.cps.2017.02.013.
[27]	HulsCK, DetlefsC. Trauma in pregnancy[J]. Semin Perinatol, 2018, 42(1): 13-20. DOI: 10.1053/j.semperi.2017.11.004.
[28]	SeyedzadehMS, RezavandN, SeyedzadehA, et al. Maternal and fetal outcome of burn during pregnancy: 3rd report from Kermanshah, Iran[J]. Int J Burns Trauma, 2021, 11(2): 90-95.
[29]	OuseyK, HodgsonH, RipponMG, et al. Hydro-responsive wound dressings for treating hard-to-heal wounds: a narrative review of the clinical evidence[J]. J Wound Care, 2021, 30(12): 980-992. DOI: 10.12968/jowc.2021.30.12.980.
[30]	BoudraR, RamseyMR. Understanding transcriptional networks regulating initiation of cutaneous wound healing[J]. Yale J Biol Med, 2020, 93(1): 161-173.
[31]	ZhuY, MaS, DengHY, et al. The characteristics of organ function damage of hemorrhagic shock in hot environment and the effect of hypothermic fluid resuscitation[J]. Shock, 2022, 57(4): 526-535. DOI: 10.1097/SHK.0000000000001873.
[32]	ZhuYG, YangML, DingLT, et al. Fluid resuscitation based on pulse contour cardiac output monitoring is associated with improved prognosis in adult severe burn patients: a retrospective cohort study[J]. Ann Palliat Med, 2021, 10(10): 10904-10912. DOI: 10.21037/apm-21-2587.
[33]	PrasannaM, SinghK. Early burn wound excision in "major' burns with "pregnancy': a preliminary report[J]. Burns, 1996, 22(3): 234-237. DOI: 10.1016/0305-4179(95)00113-1.
[34]	BartleEJ, SunJH, WangXW. Burns in pregnancy[J]. J Burn Care Rehabil, 1988, 9(5): 485-487. DOI: 10.1097/00004630-198809000-00008.
[35]	BrelandA, Craft-CoffmanB, ThomasN,et al. Cesarean delivery in the management of pregnancy complicated by burn injuries[J]. Ann Plast Surg, 2021, 86(4S Suppl 4): S458-459. DOI: 10.1097/SAP.0000000000002786.