22 feb. 2011 MANAGEMENTUL ARSURII IN TIMPUL SARCINII – PREZENTARE DE CAZ SI ANALIZA LITERATURII
A. Zbuchea*, C. Vladescu*, Nicoleta Vladescu**
* Spitalul Judetean de Urgenta Ploiesti
** Clinica MedLife, Bucureşti
Rezumat
Desi agresiunea termica in timpul sarcinii este putin frecventa, aceasta situatie delicata necesita un management adecvat si o abordare pluridisciplinara, pentru a asigura o ingrijire medicala optima, atat mamei cat si fatului. Prezenta lucrare prezinta cazul unei paciente in varsta de 29 ani, insarcinata in 35 saptamani, care a suferit o arsura prin lichid fierbinte gradul IIA-IIB pe 20% din suprafata corpului si la care cursul sarcinii s-a incheiat prin operatia cezariana, cu evolutie ulterioara favorabila, atat pentru mama, cat si pentru fat. De asemenea, se realizeaza o trecere in revista a literaturii de specialitate, care subliniaza importanta varstei fatului si a gravitatii arsurii, pentru orientarea deciziei terapeutice. Supravietuirea fatului inainte de 28 de saptamani de sarcina este dependenta de cea a mamei, dar dupa 32 de saptamani, supravietuirea fatului devine din ce in ce mai sigura si extragerea acestuia este recomandata de principiu, in arsurile mai grave.
Abstract – Management of burn injury in pregnancy – case report and literature review
Although thermal aggression during pregnancy is uncommon, this delicate situation requires proper management and a multidisciplinary approach to provide optimal care, both mother and fetus. This paper presents the case of a patient aged 29 years, 35 weeks pregnant, who suffered a scald injury level IIA-IIB 20% of the body. Her pregnancy ended by caesarean section, with subsequent favorable evolution , for both the mother and the fetus. This article also performs a review of the literature, which emphasizes the importance of fetal age and severity of the burn, to guide therapeutic decision. The survival of the fetus before 28 weeks of pregnancy is dependent on the mother, but after 32 weeks, fetal survival becomes increasingly safe and fetal extraction principle is recommended in more severe burns.
Keywords: burns, pregnancy, fetus viability, fetus extraction