Charles G, Marhic C, Guilbaud J, Carsin H, Ponties J E, Perrot J, Hornez G
Service de Gynécologie-Obstétrique, Hôpital d'Instruction des Armées Bégin, Saint-Mandé.
J Gynecol Obstet Biol Reprod (Paris). 1989;18(4):501-5.
The authors report a case of a severe thermal burn (70% of the surface of the body) in a pregnant woman who had 15 weeks amenorrhoea. The survival of the mother and the continuation of the pregnancy to term allowed a normal live baby to be born. As far as the authors know this is the fourth case history of a severe (more than 60% of the body) burn published occurring in the first trimester of pregnancy and carried through successfully to term. A study of the literature has shown that the physiopathological results of severe burns do explain the usually poor prognosis for mother and fetus. Large quantities of prostaglandins are released into the circulation of the mother because of the thermal insult to tissues and because of the infection that usually accompanies such burns. These prostaglandins can stimulate the myometrium, which gives rise to fatal obstetric complications. The urgent acute treatment for a severe burn in a pregnant woman, which should preferably be carried out in a special centre, consists in water and electrolyte resuscitation, assisted respiration and prevention of bacterial contamination. These measures are just as important for the fetus. At the same time obstetric care should be started. Good collaboration between the obstetricians and those who carry out the resuscitation all bring about the measures that are needed to allow the mother and fetus to survive.
作者报告了一例怀孕15周的孕妇发生严重热烧伤（占体表面积70%）的病例。母亲存活且妊娠持续至足月，使一名正常活产婴儿得以出生。据作者所知，这是第四例发表的在妊娠早期发生严重烧伤（超过体表面积60%）并成功维持至足月的病例。文献研究表明，严重烧伤的生理病理结果确实解释了母亲和胎儿通常预后不良的原因。由于组织受到热损伤以及此类烧伤通常伴随的感染，大量前列腺素释放到母亲的循环系统中。这些前列腺素可刺激子宫肌层，从而引发致命的产科并发症。对怀孕妇女严重烧伤的紧急急性治疗，最好在专门的中心进行，包括水和电解质复苏、辅助呼吸以及预防细菌污染。这些措施对胎儿同样重要。与此同时，应开始产科护理。产科医生与进行复苏的人员之间的良好协作，共同促成了使母亲和胎儿存活所需的措施。
