Burn Injuries during Pregnancy Case Studies and Literatures Review

妊娠中的燙傷治療原則

周爾康(Erh-Kang Chou) ； 楊瑞永(Jui-Yung Yang) ； 蔡豐州(Feng-Chou Tsai) ； 張松源(Sung-Yuan Chang) ； 莊秀樹(Shiow-Shuh Chuang) ； 陳大正(Da-Jeng Chen)

《中華民國整形外科醫學會雜誌》 11卷4期 (2002/12) Pp. 282-286

https://doi.org/10.7096/JPSA.200212.0282

摘要

雖然懷孕的過程並不會影響燒燙傷的預後，但是對於胎兒與母親的治療照顧，則會因為燒燙傷面積深度的不同，及有無其他合併症，而有所調整。治療的重心，應該以母親為主，不應一昧的為了保住胎兒而影響了母親的救治。我們報告一例失敗的安胎經驗以及燙傷的治療作為借鏡。失敗的可能原因，在文中有所討論。由此個例得到的經驗：病患入院後，首先應評估女性病人懷孕與否，如果是，又是否屬於高危險群。高危險的孕婦，在胎兒三十二周以上，則建議儘快分娩。若胎兒發育還不完全，母親給予支持性療法，安胎藥物將不被建議。

並列摘要

Major burns during pregnancy present a significant challenge to burn care units, who must consider both fetal and maternal salvage and management. A 21 weeks pregnant woman suffered from second to third degree flame burns, covering 42% total body surface area (TBSA), specifically the face, trunk and upper extremity. The woman also had inhalation injuries. Burn wound debridement was preformed and tocolytics was given to control uterine contractions at the burn center of Chang Gung Memorial Hospital. The condition of the patient deteriorated further following treatment, with burn wound infection, sepsis and preterm labor all developing. The fetus was lost and the mother died on the 14 and 2lth days post-admission, respectively. This investigation inspired us to report this patient and reviewed the literatures over the recent last 20 years. Timely intervention and comprehensive evaluation should be applied in treating severely burned pregnant women. Termination of the pregnancy or supportive treatment without tocolytics agent may be preferable to aggressive tocolysis for these patients.

並列關鍵字

Pregnancy ； burn ； tocolysis