Obstetric implications of burns in pregnancy.

Analysis of 50 patients with burns in pregnancy has allowed the objective consideration of obstetric implications. Patients in the second and third trimester of pregnancy with burns of greater than or equal to 50% should be delivered immediately as maternal death is otherwise certain and fetal survival rate is not improved by waiting. Vaginal delivery has always proved possible, even in the presence of perineal burns but caesarean section should be considered and may be preferred. Patients in the first trimester may survive with more extensive burns and possible reasons for this are discussed. Pregnancy testing on admission should be mandatory in burns of women of reproductive age. In patients with burns of less than 40% in the second and third trimesters, spasmolytics should be used to suppress spontaneous labour and to cover operations. Greater fetal maturity without worsening maternal prognosis can thus be achieved. Insufficient data exist to recommend this for burns of between 40 and 50%.