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burns_pregnancy-Benjamin

burns_pregnancy-Benjamin - Burns in Pregnancy...

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December 24, 2011 1 Burns in Pregnancy Dr.Mridula A. Benjamin Dept of Obs and Gyn RIPAS Hospital
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2 Introduction Burns is an important subject in trauma management But burns in pregnancy is not a topic mentioned in obstetric texts or books on burn care The aim of this literature review was to understand the impact burns has on pregnancy and maternal and fetal survival and the subtle differences in the management of pregnant burn victims
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3 Materials and methods An Internet search was done using Pubmed search engine to collect case reports and articles on the topic Statistics of Burns unit, RIPAS Hospital
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4 Incidence 7% in USA (Amy et al. Fort Houston), The highest of all burn incidences in pregnancy was found in India, ranging from 7%, calculated by Akhtar (Nagpur), to 13.3%, reported by Jain (Bhilai) Of the 379 cases reported in the literature between 1958 and the present day that have come to our attention, 129 (34%) occurred in India
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5 Causes Accidental Intentional 72.55% 27.45%
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6 Causes 0 5 10 15 20 25 30 35 40 Scalding Flame Flash Electrical chemical Friction
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7 Place of occurrence Home Garden Work RTA Others 62% 25% 8% 2% 3%
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8 Brunei statistics 2006 Males Females 123 163 Total Burn Patients: 286 Inpatient Outpatient 244 42
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9 Brunei statistics Males Females 27 15 1st decade 2nd decade 3rd decade 4th decade 5th decade 2 3 3 5 2
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10 Effect of Burns Slight burns had no effect on the course of pregnancy, while burns of at least 35% TBSA were capable of provoking early labour and the loss of the foetus following intrauterine death within a week of the burn
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11 Old school of thought Onset of labour in a premature delivery is due to secretion of adrenocortical hormones related to stress. Spontaneous miscarriage and premature delivery are due to the synthesis and release of prostaglandins (responsible for early uterine contractions) from the skin in the burn area
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12 Current opinion
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13 Current opinion After burns there is increased capillary permeability and third space loss leading to hypovolemia This leads to hypotension if the patient is inadequately resuscitated This leads to placental insufficiency, fetal ischemia, hypoxia and acidosis All these events lead to premature labor
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