Background:

Pregnancy results in profound physiologic changes in otherwise medically fit females with marked changes in cardiovascular, respiratory and metabolic systems.

Avoiding dental treatment, either in the lead up to pregnancy or during pregnancy sometimes however may result in spreading odontogenic infections.  Management of spreading odontogenic infections is at best complicated, particularly if swelling in the neck occurs with a tendency to airway obstruction.

Objectives:

The objective of this study was to review the management of patients presenting with severe odontogenic infections and who are also pregnant.

Methods:

A retrospective clinical audit was conducted of all female patients admitted to the Royal Adelaide Hospital by the Oral and Maxillofacial Surgery Unit from 1999 to 2009 with severe odontogenic infections. Pregnant patients were identified and their age, medical history, previous obstetric and gynaecological history, stage of current pregnancy, presenting infection, diagnosis and management were recorded, as well as the outcome of the pregnancy.

Principle Findings:

A total of 346 female patients were admitted to the Royal Adelaide Hospital under the care of the Oral and Maxillofacial Surgery Unit with an admission diagnosis of severe odontogenic infection and five were pregnant. Besides surgical and anaesthetic assessment, mother and foetus were assessed by the Obstetric and Gynaecology Unit. In all, five with severe infection were successfully resolved and four proceeded to a normal delivery with a healthy child. The remaining patient had an already planned therapeutic abortion.

Conclusion: Pregnant patients with severe odontogenic infections require urgent referral to a tertiary hospital with full surgical, anaesthetic and obstetric services. This allows appropriate management of the complex requirements of mother and foetus.