Substance abuse in pregnancy

Question 1

Mx of etoh abuse

Answer 1

• MDI-Obs/Addiction/SW/Diet/Paeds
• M risk - withdrawal/malnutrition
• F risk no safe lvl, IUGR/SB/FASD
• Screen end-organ dmg (LFT/albumin/liver USS)
• Screen for other substance…
• Screen for DV…
• Supplements - thiamine 100mg d
• Follow-up - regular OP
• PN - withdrawal-diaz, breastfeeding, SW input

Question 2

Mx of smoking in preg

Answer 2

• M risk - resp infection/abruption
• F risk - PTB/LWB/IUGR/SB/SIDs
• REF-Quit line+/-CBT +/-Nicotine replace
• PN - SIDS, encourage BF, no COCP to smoker >35

Question 3

Mx of IVDU - opioid

Answer 3

• MDI..D&A
• Methadone
• Hx murmur/fever/hematurai ?IE +/- TTE