Abstract
Opioid abuse has increased dramatically among women of childbearing age, with a tripling in the nonmedical use of opioids and deaths due to narcotic overdose within the last decade. Acute untreated withdrawal can be life threatening to both mother and fetus. Abuse of other drugs and concurrent psychiatric illness occur frequently. Poorer obstetric and neonatal outcomes to include preterm delivery and neonatal abstinence syndrome occur, but there appears to be no increased incidence of congenital anomalies. Acute detoxification during pregnancy is to be avoided, long-term narcotic therapy should be maintained throughout pregnancy, and obstetric management in the treated parturient differs little from that of the non-opioid-dependent parturient. Neuraxial anesthesia is the preferred anesthetic choice for labor and vaginal and cesarean delivery. Use of a multimodal approach for post-cesarean delivery pain control is recommended.
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Baysinger, C.L. (2018). Opioids. In: Mankowitz, S. (eds) Consults in Obstetric Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-59680-8_114
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DOI: https://doi.org/10.1007/978-3-319-59680-8_114
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