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opioids and pregnancy

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https://www.readbyqxmd.com/read/28626420/restless-legs-syndrome-from-pathophysiology-to-clinical-diagnosis-and-management
#1
REVIEW
Shiyi Guo, Jinsha Huang, Haiyang Jiang, Chao Han, Jie Li, Xiaoyun Xu, Guoxin Zhang, Zhicheng Lin, Nian Xiong, Tao Wang
Restless legs syndrome (RLS), a common neurological sensorimotor disorder in western countries, has gained more and more attention in Asian countries. The prevalence of RLS is higher in older people and females. RLS is most commonly related to iron deficiency, pregnancy and uremia. The RLS symptoms show a significant circadian rhythm and a close relationship to periodic limb movements (PLMs) in clinical observations, while the pathophysiological pathways are still unknown. The diagnostic criteria have been revised in 2012 to improve the validity of RLS diagnosis...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28594753/opioid-use-in-pregnancy-neonatal-abstinence-syndrome-and-childhood-outcomes-executive-summary-of-a-joint-workshop-by-the-eunice-kennedy-shriver-national-institute-of-child-health-and-human-development-american-college-of-obstetricians-and-gynecologists-american
#2
Uma M Reddy, Jonathan M Davis, Zhaoxia Ren, Michael F Greene
In April 2016, the Eunice Kennedy Shriver National Institute of Child Health and Human Development invited experts to a workshop to address numerous knowledge gaps and to review the evidence for the screening and management of opioid use in pregnancy and neonatal abstinence syndrome. The rising prevalence of opioid use in pregnancy has led to a concomitant dramatic fivefold increase in neonatal abstinence syndrome over the past decade. Experts from diverse disciplines addressed research gaps in the following areas: 1) optimal screening for opioid use in pregnancy; 2) complications of pregnancy associated with opioid use; 3) appropriate treatments for pregnant women with opioid use disorders; 4) the best approaches for detecting, treating, and managing newborns with neonatal abstinence syndrome; and 5) the long-term effects of prenatal opioid exposure on children...
June 7, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28594601/a-parenting-education-program-for-women-in-treatment-for-opioid-use-disorder-at-an-outpatient-medical-practice
#3
Linda S Kahn, Whitney E Mendel, Kyla L Fallin, Elizabeth A Borngraber, Thomas H Nochajski, William E Rea, Richard D Blondell
Opioid use during pregnancy poses serious risks for the mother and the unborn child. Opioid-use disorder may be managed with medication-assisted treatment (MAT) in an outpatient setting, but few MAT practices specifically address the challenges faced by pregnant women. This article describes a medical office-based educational support group for women in MAT for opioid-use disorder who were pregnant and/or parenting young children. Focus groups were conducted to elicit patient feedback. Women indicated that they found the educational support groups beneficial and offered suggestions...
June 8, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28591085/influence-of-oprm1-polymorphism-on-post-operative-pain-after-intrathecal-morphine-administration-in-italian-patients-undergoing-elective-cesarean-section
#4
Eleonora Pettini, Massimo Micaglio, Ubaldo Bitossi, Angelo Raffaele De Gaudio, Duccio Rossi Degl'Innocenti, Lorenzo Tofani, Vittorio Limatola, Chiara Adembri, Alessandro Di Filippo
OBJECTIVES: the aim of this prospective observational study was to evaluate the influence of OPRM1 polymorphism on the analgesic efficacy (including VAS scores and requirement for rescue analgesia) of a standard dose of intrathecal morphine METHODS:: an Italian cohort of 63 parturients, scheduled for elective cesarean section at a tertiary University Hospital, received a spinal anesthesia with hyperbaric bupivacaine and morphine 100 mcg. For the first 48 hours in the post-operative period the patients received acetaminophen 1 g IV q6hr...
June 6, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28562278/maternal-use-of-opioids-during-pregnancy-and-congenital-malformations-a-systematic-review
#5
REVIEW
Jennifer N Lind, Julia D Interrante, Elizabeth C Ailes, Suzanne M Gilboa, Sara Khan, Meghan T Frey, April L Dawson, Margaret A Honein, Nicole F Dowling, Hilda Razzaghi, Andreea A Creanga, Cheryl S Broussard
CONTEXT: Opioid use and abuse have increased dramatically in recent years, particularly among women. OBJECTIVES: We conducted a systematic review to evaluate the association between prenatal opioid use and congenital malformations. DATA SOURCES: We searched Medline and Embase for studies published from 1946 to 2016 and reviewed reference lists to identify additional relevant studies. STUDY SELECTION: We included studies that were full-text journal articles and reported the results of original epidemiologic research on prenatal opioid exposure and congenital malformations...
May 19, 2017: Pediatrics
https://www.readbyqxmd.com/read/28561914/opioid-use-disorder-in-pregnancy
#6
REVIEW
Van Roper, Kim J Cox
Opioid use disorder (OUD) in pregnancy has increased significantly in the past 10 years. Women with OUD may often be undertreated or untreated because of limited accessibility to treatment, particularly in rural areas. Because detoxification is not recommended during pregnancy due to the potential for adverse outcomes in the fetus and a high risk of relapse for the woman, more primary care providers need to be well versed in opioid-assisted therapy. In addition, recent changes in Food and Drug Administration regulations now allow nurse practitioners and physician assistants with specialized training to provide buprenorphine treatment for pregnant women with OUD in primary care settings...
May 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28543284/in-utero-oxcarbazepine-exposure-and-neonatal-abstinence-syndrome-case-report-and-brief-review-of-the-literature
#7
Chao-Yang Chen, Xing Li, Ling-Yue Ma, Peng-Hui Wu, Ying Zhou, Qi Feng, Yi-Min Cui
Oxcarbazepine is a second-generation antiepileptic drug that is used to treat partial seizures. Although it has been increasingly used in pregnant women, its fetal safety has not been fully validated. We describe a 12-hour-old neonate who developed neonatal abstinence syndrome (NAS) following intrauterine exposure to oxcarbazepine. The neonate was born by cesarean section to a mother who took oxcarbazepine 300 mg/day for treatment of seizures throughout her pregnancy. Approximately 12 hours after birth, the infant developed paroxysmal jitter, which mainly presented as increased excitability, irritability, limb shaking, and increased muscle tone...
May 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28543191/methadone-buprenorphine-and-naltrexone-for-the-treatment-of-opioid-use-disorder-in-pregnant-women
#8
Tran H Tran, Brooke L Griffin, Rebecca H Stone, Kathleen M Vest, Timothy J Todd
Pregnant women with opioid use disorder can be treated with methadone, buprenorphine, or naltrexone to reduce opioid use and improve retention to treatment. In this review, we compare the pregnancy outcomes of methadone, buprenorphine, and naltrexone in clinical trials and discuss the potential behavioral and developmental effects of these agents seen in offspring in animal studies. Important clinical considerations in the management of opioid use disorder in pregnant women and their infants are also discussed...
May 24, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28536981/a-retrospective-cohort-study-of-birth-outcomes-in-neonates-exposed-to-naltrexone-in-utero-a-comparison-with-methadone-buprenorphine-and-non-opioid-exposed-neonates
#9
Erin Kelty, Gary Hulse
BACKGROUND: Naltrexone may provide a suitable alternative to methadone and buprenorphine in the treatment of pregnant opioid-dependent women; however, little is known about its effects on neonatal morbidity and mortality. OBJECTIVE: The aim was to evaluate the health of neonates exposed to naltrexone in utero, and compare it with outcomes in neonates exposed to methadone or buprenorphine and a non-exposed control group. METHODS: Sequential cohorts of Western Australian (WA) opioid-dependent women treated with implant naltrexone, oral methadone or sublingual buprenorphine were identified via records from a drug and alcohol clinic (Subiaco, WA) for naltrexone and state prescribing records for methadone and buprenorphine...
May 23, 2017: Drugs
https://www.readbyqxmd.com/read/28536980/a-retrospective-cohort-study-of-obstetric-outcomes-in-opioid-dependent-women-treated-with-implant-naltrexone-oral-methadone-or-sublingual-buprenorphine-and-non-dependent-controls
#10
Erin Kelty, Gary Hulse
BACKGROUND: Opioid pharmacotherapies play an important role in the treatment of opioid-dependent women; however, very little is known about the safety of naltrexone in pregnant patients. OBJECTIVE: This study examined the obstetric health of opioid-dependent women who were treated with implant naltrexone during pregnancy, and compared them with women treated with methadone and/or buprenorphine and a cohort of non-opioid-dependent controls. METHODS: Women treated with implant naltrexone, oral methadone or sublingual buprenorphine between 2001 and 2010, along with a cohort of age-matched controls, were linked with records from midwives, hospital and emergency departments (EDs) and the death registry to identify pregnancy and health events that occurred during pregnancy and in the post-partum period...
May 23, 2017: Drugs
https://www.readbyqxmd.com/read/28519244/neonatal-abstinence-syndrome-update-on-diagnostic-and-therapeutic-strategies
#11
Genny Raffaeli, Giacomo Cavallaro, K Karel Allegaert, Enno Diederik Wildschut, Monica Fumagalli, Massimo Agosti, Dick Tibboel, Fabio Mosca
Substance use among pregnant women is a major public health issue. Both prescription opioid use and illicit opioid abuse have increased dramatically in recent years. Prolonged in utero drug exposure may result in neonatal abstinence syndrome (NAS), an acute multisystemic clinical entity that occurs in the first days of life. This syndrome is caused by abrupt discontinuation of fetal exposure to licit or illicit drugs chronically consumed by the mother during pregnancy and transmitted to the fetus through the placenta...
May 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28500694/trends-of-neonatal-abstinence-syndrome-epidemic-and-maternal-risk-factors-in-florida
#12
Xi Wang, Yanmin Zhu, Chintan V Dave, Adel A Alrwisan, Stacy A Voils, Almut G Winterstein
OBJECTIVE: This study aimed to examine secular trends of (i) maternal prescription opioid use in late pregnancy, (ii) neonatal abstinence syndrome (NAS) stratified by late maternal prescription opioid use, and (iii) maternal risk factors among NAS deliveries. METHODS: Women with a live birth who were enrolled 90 days before and 30 days after delivery in Florida Medicaid Analytic Extract billing records linked to birth certificates from 2000 to 2010 were identified for the study...
May 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28499376/benefits-of-preparing-for-childbirth-with-mindfulness-training-a-randomized-controlled-trial-with-active-comparison
#13
Larissa G Duncan, Michael A Cohn, Maria T Chao, Joseph G Cook, Jane Riccobono, Nancy Bardacke
BACKGROUND: Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education. METHODS: This study, the Prenatal Education About Reducing Labor Stress (PEARLS) study, is a randomized controlled trial (RCT; n = 30) of a short, time-intensive, 2...
May 12, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28459984/treatment-of-opioid-use-disorder-during-pregnancy-may-increase-cases-of-neonatal-abstinence-syndrome-reply
#14
Joshua D Brown, Jeffery C Talbert
No abstract text is available yet for this article.
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28459976/treatment-of-opioid-use-disorder-during-pregnancy-and-cases-of-neonatal-abstinence-syndrome
#15
Davida M Schiff, Stephen W Patrick
No abstract text is available yet for this article.
May 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28437302/pain-management-in-the-opioid-dependent-pregnant-woman
#16
Rebecca R Safley, Jamie Swietlikowski
Opioid dependence is an epidemic in the United States, and the percentage of pregnant women who are opioid dependent has increased dramatically in the last decade. Pain management, already a concern for intrapartum and postpartum care, is complicated in the context of opioid dependence. This clinical review surveys the literature on pain management in opioid-dependent pregnant women to summarize current consensus and evidence to guide clinical practice. Points of consensus for pain management in opioid-dependent pregnant women include continual opioid maintenance therapy throughout the pregnancy and the postpartum period; adequate management of acute pain; the contraindication of opioid agonist-antagonists for pain management; and the need for interdisciplinary teams using a multimodal approach to provide optimal care to opioid-dependent pregnant women...
April 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28426507/peripartum-anesthetic-management-of-the-opioid-tolerant-or-buprenorphine-suboxone-dependent-patient
#17
Aileen Pan, Mark Zakowski
Opioid abuse and dependence continues to rise in both the general population and pregnancy, with opioid overdose deaths having quadrupled in the last 15 years. Illicit drug use in last 30 days of pregnancy was over 4% with almost 0.6% documented maternal opiate use at time of birth. The management of the opioid-tolerant, buprenorphine-dependent or methadone-dependent patient in the peripartum period is reviewed. Options for treatment of opioid dependence, acute pain management, and perioperative multimodal analgesia are discussed...
June 2017: Clinical Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28408072/nonmedical-use-of-prescription-opioids-among-pregnant-u-s-women
#18
Katy B Kozhimannil, Amy J Graves, Robert Levy, Stephen W Patrick
OBJECTIVES: Nonmedical use of opioids during pregnancy is associated with adverse outcomes for women and infants, making it a prominent target for prevention and identification. Using a nationally representative sample, we determined characteristics of U.S. pregnant women who reported prescription opioid misuse in the past year or during the past month. METHODS: We used data from the National Survey on Drug Use and Health (2005-2014) in a retrospective analysis...
May 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28407220/patient-controlled-analgesia-with-remifentanil-versus-alternative-parenteral-methods-for-pain-management-in-labour
#19
REVIEW
Stephanie Weibel, Yvonne Jelting, Arash Afshari, Nathan Leon Pace, Leopold Hj Eberhart, Johanna Jokinen, Thorsten Artmann, Peter Kranke
BACKGROUND: Multiple analgesic strategies for pain relief during labour are available. Recently remifentanil, a short-acting opioid, has recently been used as an alternative analgesic due to its unique pharmacological properties. OBJECTIVES: To systematically assess the effectiveness of remifentanil intravenous patient-controlled analgesia (PCA) for labour pain, along with any potential harms to the mother and the newborn. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (9 December 2015), ClinicalTrials...
April 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28406856/treating-women-who-are-pregnant-and-parenting-for-opioid-use-disorder-and-the-concurrent-care-of-their-infants-and-children-literature-review-to-support-national-guidance
#20
Stacey L Klaman, Krystyna Isaacs, Anne Leopold, Joseph Perpich, Susan Hayashi, Jeff Vender, Melinda Campopiano, Hendrée E Jones
OBJECTIVES: The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children...
May 2017: Journal of Addiction Medicine
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