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Chapter 75 - Substance Use in Pregnancy

from Section 13 - Miscellaneous Conditions

Published online by Cambridge University Press:  23 February 2023

By
Alexa Eberle  and
Amira El-Messidi
Edited by
Amira El-Messidi  and
Alan D. Cameron
Amira El-Messidi
Affiliation:
McGill University, Montréal
Alan D. Cameron
Affiliation:
University of Glasgow
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Summary

You are called to the A&E (E.R.) department of your tertiary center to assist in the care of your patient, a 22-year-old primigravida at 14+4 weeks’ gestation who presents, accompanied by her partner, with a six-hour history of nausea, vomiting, and headache since her last consumed six-daily standard drinks of beer yesterday. At last week’s baseline prenatal visit, you learned that medical history is only significant for an alcohol use disorder, for which she was motivated to enroll in a treatment program. Your medical notes indicate a normal body habitus and unremarkable physical exam. Prenatal investigations and first-trimester aneuploidy screening tests were normal. You had prescribed vitamins containing folic acid; the patient was not experiencing nausea or vomiting of pregnancy.

Keywords

Chronic alcohol use, alcoholism, pregnancy, prenatal alcohol-use disorderAlcohol-screening questionnairesPerinatal risks, maternal-fetal complicationsFetal alcohol spectrum disordersAntepartum, intrapartum, postpartum managementBreastfeedingMarijuana-associated pregnancy complicationsSleep health in pregnancyCocaine-associated pregnancy complications
Type
Chapter
Information
OSCEs in Obstetrics and Maternal-Fetal Medicine
An Evidence-Based Approach
 , pp. 946 - 954
Publisher: Cambridge University Press
Print publication year: 2023

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References

Suggested Readings

American College of Obstetricians and Gynecologists. Committee on Health Care for Underserved Women. Committee opinion no. 496: At-risk drinking and alcohol dependence: obstetric and gynecologic implications. Obstet Gynecol. 2011;118(2 Pt 1):383–388.Google Scholar
Committee on Obstetric Practice. Committee Opinion No. 722: marijuana use during pregnancy and lactation. Obstet Gynecol. 2017;130(4):e205–e209.Google Scholar
Department of Health. UK Chief Medical Officers’ alcohol guidelines review: summary of the proposed new guidelines. 2016. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/489795/summary.pdf. Acessed April 22, 2022.Google Scholar
DeVido, J, Bogunovic, O, Weiss, RD. Alcohol use disorders in pregnancy. Harv Rev Psychiatry. 2015;23(2):112–121.CrossRefGoogle ScholarPubMed
Graves, L, Carson, G, Poole, N, et al. Guideline No. 405: screening and counselling for alcohol consumption during pregnancy. J Obstet Gynaecol Can. 2020 Sep;42(9):1158–1173.CrossRefGoogle ScholarPubMed
Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy. Geneva: World Health Organization; 2014.Google Scholar
Dejong, K, Olyaei, A, Lo, JO. Alcohol use in pregnancy. Clin Obstet Gynecol. 2019;62(1):142–155.Google Scholar
Metz, TD, Borgelt, LM. Marijuana use in pregnancy and while breastfeeding. Obstet Gynecol. 2018;132(5):1198–1210.CrossRefGoogle ScholarPubMed
Ordean, A, Wong, S, Graves, L. No. 349 – substance use in pregnancy. J Obstet Gynaecol Can. 2017;39(10):922–937.CrossRefGoogle ScholarPubMed
Thibaut, F, Chagraoui, A, Buckley, L, et al. WFSBP* and IAWMH** Guidelines for the treatment of alcohol use disorders in pregnant women. World J Biol Psychiatry. 2019;20(1):17–50. [Correction in World J Biol Psychiatry. 2019 Apr 11]CrossRefGoogle ScholarPubMed

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