Drugs In Pregnancy Flashcards
Medical effects
Infectious diseases Poor nutrition/malabsorption Poor dentition Dermatological problems cardio Resp Neurological Psychiatric co-morbid in 60-80%
Obstetric Effects
Increased miscarriage Increased perinatal and infant mortality Threats to maternal and infant health Increased Anaheim’s Increased abruption Need for more analgesia in lab/del
Neonatal effects
Increased low birth weight Increased prematurity Increased admission to NICU Withdrawal Neonatal meds Child protection issues SIDS
Features of FAS
Cranio-facial abnormalities Absent philtrum Broad upper lip Flat nasal bridge Hypoplastic upper vermillion Micrognathia Microphthalmia Short nose Short palpebral fissures
Major abnormalities
Brain defects
Cardiac defects
Spinal defects, limb defects, genitourinary defects
Amphetamines and pregnancy
Increased risk pre-term delivery
Depression CNS with long use
Can suppress maternal appetite
Amphetamine mech of action
Increased synaptic dopamine, noradrenaline, and serotonin
Mimics monoamine neurotransmitter
Psychosis due to increase in dopamine release
Depression associated with depletion of these transmitters
Meth effects (done on rats)
First half of gestation - impaired sensorimotor development
Second half of gestation - decreased birth weight, reduced cerebellum function
Cocaine effects on neonate
IUGR Preterm labour Abruption IVH Cerebral infarction Brain lesions NEC
Heroin effects
Anaheim’s
IUGR
Preterm labour
Reduced pain threshold
Smoking fetal risks
Miscarriage Fetal death Preterm delivery IUGR (2x increased risk) Lower BWs (200-300g lighter than non-smokers SIDS Lung and resp abnormalities More behavioral problems
FAS measurable deficits
Facial malformations - flat elongated philtrum, thin upper lip, small wide apart eyes and small head circumference
Brain and CNS disorders
Growth retardation
Placental pathology of smoking
Disrupts implantation process and interferes with the transformation of uterine spiral arteries
Potential complications of smoking
Miscarriage Ectopic Abruption PPROM Preterm birth Neonatal morbidity and mortality
Effect of cannabis on neonates
Neurodevelopmental deficit or delay —cognitive deficit —visuospatial dysfunction —impulsivity —inattention —depression
T-ACE - alcohol abuse screen
Tolerance
Annoyance
Cut Down
Eye opener
