Care of the Burned Pregnant Patient

This chapter defines the care of severely burned obstetric patients in the rare event the burn team is faced with this complex physiologic situation. The mortality rates for severely burned pregnant women and their fetuses are the highest among the burn population. The current dearth of literature predominantly advocates treating pregnant women much as nonpregnant victims would be: early wound excision and coverage, aggressive fluid resuscitation, empiric antibiotic coverage, and adequate nutritional support. One distinction is the early administration of antenatal corticosteroids for fetal development. The lower limit of periviability is now gestational week 22 or a fetal weight of 500 g, defining the earliest viable emergent delivery stage. Optimal management requires multidisciplinary cooperation; consultation from high-risk obstetricians, neonatologists, pharmacologists, and psychiatrists ought to augment the burn team. It will be the continuous recommendation of the authors that systematic research be performed on how best to treat both patients, mother and baby.