Maternal Substance Abuse ✅ Flashcards
(41 cards)
What % of women of child-bearing age are affected by alcoholism?
1-2%
What is the effect of alcohol on a developing embryo?
Alcohol and its acetaldehyde metabolite impairs embryogenesis by disrupting cellular differentiation and growth, inhibiting cell migration, and disrupting DNA synthesis
What is the name of the clinical syndrome caused by alcohols effect on embryogenesis?
Fetal alcohol spectrum disorder (FASD)
What is the incidence of fetal alcohol syndrome?
1-2 per 1000 live births
What is the recommended maximum intake of alcohol during pregnancy?
None
Why is it recommended that pregnant women avoid alcohol completely?
The effect of low or moderate alcohol ingestion or occasional binge drinking is unknown
What systems does fetal alcohol syndrome affect?
- Neurological
- Craniofacial
- Cardiac
- Limb
What are the neurological features of fetal alcohol syndrome?
- Microcephaly
- Abnormalities of corpus callous, cerebellar vermis, and dentate gyrus
- Cognitive impairment and developmental delay
What are the craniofacial features of fetal alcohol syndrome?
- Short palpebral fissures
- Smooth philtrum
- Maxilla hypoplasia
- Cleft palate
- Micrognathia
What are the cardiac features of fetal alcohol syndrome?
VSD
What are the limb features of fetal alcohol syndrome?
Joint abnormalities
What is neonatal abstinence syndrome most commonly associated with?
Chronic narcotic abuse
What other classes of drugs can be associated with neonatal abstinence syndrome?
- Non-narcotic sedatives
- Stimulants
- Anti-depressants
- Anti-epileptics
- Neuroleptics
What effect does chronic narcotic misuse have on a developing foetus?
It stimulates the opiate receptors in the locus cerulean of the fetal brainstorm, and acclimatisation occurs
What happens when narcotics are suddenly removed at birth?
Increased adrenergic activity of the locus ceruleus causes withdrawal symptoms
What can complicate the situation in neonatal abstinence syndrome?
Multiple drug use
Is opiate replacement therapy recommended in pregnant women?
Yes
What is used for opiate replacement therapy in pregnant women?
Methadone
What are the advantages of opiate replacement therapy in pregnant women?
- Clinical improvement
- Better control of drug use
- Less crime
- Reduced risk of hepatitis B and C, and HIV in IV users
How long after birth is the onset of opiate withdrawal symptoms in neonatal abstinence syndrome?
Usually within 48 hours of birth, but can be delayed for up to 2 weeks
What systems does opiate withdrawal affect in neonatal abstinence syndrome?
- CNS
- GI
- Autonomic
What are the CNS symptoms of opiate withdrawal in neonatal abstinence syndrome?
- Irritability and high-pitched cry
- Hyperactivity with reduced periods of sleep
- Tremors
- Increased tone
- Seizures (rare)
What are the GI symptoms of opiate withdrawal in neonatal abstinence syndrome?
- Poor feeding
- Vomiting
- Diarrhoea
What are the autonomic symptoms of opiate withdrawal in neonatal abstinence syndrome?
- Sweating
- Fever
- Yawning
- Sneezing
