Dr Grace Brownlee1,2, Dr Matthew Lyon1,2, Dr Carl Lisec1,2
1Professor Stuart Pegg Adult Burns Centre, The Royal Brisbane And Women’s Hospital, Herston, Australia, 2Faculty of Medicine, The University of Queensland, St Lucia, Australia
Burns during pregnancy are rare, and present a unique management challenge given the physiological changes associated with pregnancy. Major burns in pregnant women are particularly uncommon in developed countries, and therefore are infrequently reported in the literature. As a result, there is a paucity of information regarding incidence, management principles, maternal and foetal risk factors, and overall outcomes. In a literature search, we were unable to identify any Australian publications on this topic. We conducted a literature review to identify best practice management, and reviewed our experience with burns in pregnant patients over a 20 year period at the Professor Stuart Pegg Adult Burns Centre (PSPABC).
Between 1997 and 2017, 1723 females were admitted to the PSPABC, of which 13 (<0.01%) were also pregnant. The TBSA affected in these patients ranged from 0.5 – 30% and the most common mechanism of injury was scalding from a hot liquid (50%). Nine of these patients received operative management of their burns, three of which also underwent caesarean section deliveries. No maternal or foetal deaths occurred as a direct result of burns injuries.
It is evident that the case profile and management challenges in our Burns unit are vastly different from those of developing countries, who have similarly examined their experiences. We are less practiced in the management of severe and life threatening burns in pregnant patients, as they are simply not prevalent. Development of a national/local evidence based guideline is required but challenging due to the relatively low incidence of major burns in pregnancy in Australia.
Dr Grace Brownlee is a Resident Medical Officer currently undertaking her PGY2 year at The Royal Brisbane and Women’s Hospital. She completed her medical education at the University of Queensland in 2016.