Maternal and fetal outcomes in pregnant women Presenting with burn injuries at PIMS Islamabad

Abstract

Objective: To evaluate the clinical characteristics, trimester-wise presentation, and fetomaternal outcomes of pregnant women presenting with burn injuries at Pakistan Institute of Medical Sciences (PIMS), Islamabad.

Methodology: This retrospective cohort study was conducted in collaboration between the Burn Center and Maternal and Child Health (MCH) Department at PIMS from May 2008 to October 2024. A total of 33 pregnant women with burn injuries were included after ethical approval and informed consent. Data regarding age, gestational age, total body surface area (TBSA), type and mode of burn, trimester-wise obstetrical management, and maternal and fetal outcomes were collected using a structured questionnaire. Burn severity was calculated using the Wallace Rule of Nines. Data were analyzed using SPSS version 25. Primary outcomes included maternal and fetal survival, while secondary outcomes assessed the impact of TBSA and management strategies on outcomes.

Results: The majority of patients were aged 21–30 years (63.6%). Distribution across trimesters was comparable. Flame burns were most common (75.8%), and 97% were accidental. Maternal survival was 39.4%, while fetal survival was 30.3%. Mortality strongly correlated with TBSA (p < 0.001), with 100% fetal mortality observed in burns exceeding 70% TBSA. Outcomes improved significantly over time (p = 0.007) with multidisciplinary care. Supportive therapy yielded better maternal survival in first and second trimesters, while delivery in the third trimester resulted in improved fetal survival. No-intervention management was associated with the poorest outcomes.

Conclusion: Burn severity is the strongest predictor of fetomaternal mortality. Early multidisciplinary management and trimester-specific obstetrical strategies significantly improve survival outcomes in pregnant burn patients.