Clinics in perinatology
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Pregnancy does not predispose to thermal injuries. Most burns are minor, and erythema usually subsides within 24 hours during the outpatient therapy. Severe burns during pregnancy are rare but alarming events. ⋯ Periodic ultrasonic examination and biophysical testing of the fetus are recommended. If conditions are considered unfavorable to meet fetal circulatory and oxygen demands, prompt delivery during the late second and third trimesters has been advocated if the mother's burn covers 50 per cent or more of the surface area. If the patient has instead recovered satisfactorily and there has been no evidence of fetal jeopardy or premature labor within the first week following the burn injury, the eventual delivery of a healthy-appearing, term-sized fetus is quite likely.
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In summary, trauma occurs relatively frequently among pregnant patients. Various anatomic and physiologic changes of pregnancy may alter the type of injury experienced by pregnant women. These changes may also alter the manifestations of given injuries and the treatment required to reestablish maternal-fetal hemostasis. ⋯ Rarely, a mother may expire with her living fetus undelivered, and a rapid postmortem cesarean section may save the fetal life. During the last several years, the prognosis for both trauma victims and gravid women with complicated pregnancies and their fetuses has improved markedly. Hopefully, during the next several years, the knowledge and therapeutic modalities developed to treat each group will be combined to provide optimal care for the pregnant trauma victim and her fetus.
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Clinics in perinatology · Jun 1982
ReviewIntrapartum monitoring and management of the low birth weight fetus.
All physicians responsible for the care of gravidae at high risk for preterm labor and delivery must be expert in the management of these pregnancies. Only a fraction of women who present in labor remote from term are candidates for long-term tocolysis. Whatever treatment regimen is utilized, the clinician must be familiar with their risks as well as their benefits. ⋯ For the very low birth weight infant presenting as a breech, abdominal delivery is recommended. It is important that the uterine incision, regardless of type, be large enough to allow for nontraumatic delivery of the infant. If greater improvements in the survival and outcome of low birth weight infants are to continue, it is mandatory that there be close collaboration not only between obstetrician and pediatrician, but also between all physicians and nursing staff who care for this group of high-risk patients.