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opioids and pregnancy

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https://www.readbyqxmd.com/read/28086944/prenatal-treatment-for-opioid-dependency-observations-from-a-large-inner-city-clinic
#1
Kelley Saia, Sarah M Bagley, Elisha M Wachman, Payal P Patel, Marisa D Nadas, Susan B Brogly
BACKGROUND: The objective of this study was to review changes in the prevalence of opioid use disorder in pregnancy, and to describe the prenatal care and neonatal outcomes following the implementation of buprenorphine treatment at a large US obstetrical clinic during the on-going opioid epidemic. METHODS: We conducted a retrospective cohort study of 310 women (332 pregnancies) with opioid use disorders and their neonates delivered between June 2006 and December 2010 at an obstetrical clinic in the US...
January 13, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28024988/delayed-villous-maturation-in-term-placentas-exposed-to-opioid-maintenance-therapy-a-retrospective-cohort-study
#2
Allison E Serra, Lara S Lemon, Neggin B Mokhtari, W Tony Parks, Janet M Catov, Raman Venkataramanan, Steve N Caritis
BACKGROUND: Opioid use disorder among pregnant women is associated with adverse perinatal outcomes and is increasing in the U.S. The standard of care for pregnant women with OUD is opioid maintenance therapy (OMT) including either methadone or buprenorphine, which can be initiated at any time during pregnancy. These medications are known to cross the placenta but their placental and fetal effects have not been well characterized. Delayed villous maturation, a placental finding associated with stillbirth, was observed in placentas exposed to opioid maintenance therapy...
December 23, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28018795/nephrotoxicity-of-methadone-a-systematic-review
#3
REVIEW
Samira Alinejad, Kazem Ghaemi, Mohammad Abdollahi, Omid Mehrpour
BACKGROUND: Methadone is commonly administered for chronic pain relief and treatment of opioid dependence. Concurrent with its increased consumption, toxicities and fatalities have increased. One of the adverse effects of opioid analgesics, including methadone, is that of nephrotoxicity. Opioids can have an effect on renal function through several different mechanisms. METHODS: We searched common bibliographical databases for the terms methadone, toxicity, poisoning, kidney, renal, and nephrotoxicity and summarize our findings in this review...
2016: SpringerPlus
https://www.readbyqxmd.com/read/28012859/endogenous-opiates-and-behavior-2015
#4
REVIEW
Richard J Bodnar
This paper is the thirty-eighth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2015 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia, stress and social status, tolerance and dependence, learning and memory, eating and drinking, drug abuse and alcohol, sexual activity and hormones, pregnancy, development and endocrinology, mental illness and mood, seizures and neurologic disorders, electrical-related activity and neurophysiology, general activity and locomotion, gastrointestinal, renal and hepatic functions, cardiovascular responses, respiration and thermoregulation, and immunological responses...
December 22, 2016: Peptides
https://www.readbyqxmd.com/read/27984230/transversus-abdominis-plane-block-versus-wound-infiltration-for-analgesia-after-cesarean-delivery-a-randomized-controlled-trial
#5
Mohamed Mohamed Tawfik, Yaser Mohamed Mohamed, Rania Elmohamadi Elbadrawi, Mostafa Abdelkhalek, Maiseloon Mostafa Mogahed, Hanaa Mohamed Ezz
BACKGROUND: Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single-shot local anesthetic wound infiltration for analgesia after cesarean delivery performed under spinal anesthesia. We hypothesized that the TAP block would decrease postoperative cumulative fentanyl consumption at 24 hours...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27974484/buprenorphine-norbuprenorphine-r-methadone-and-s-methadone-upregulate-bcrp-abcg2-expression-by-activating-aryl-hydrocarbon-receptor-in-human-placental-trophoblasts
#6
Naveen K Neradugomma, Michael Z Liao, Qingcheng Mao
Opioid dependence during pregnancy is a rising concern. Maintaining addicted pregnant women on long-acting opioid receptor agonist is the most common strategy to manage pregnancy drug abuse. Methadone (MET) and Buprenorphine (BUP) are widely prescribed for opiate-maintenance therapy. Norbuprenorphine (NBUP) is the primary active metabolite of BUP. These medications can cross the placenta to the fetus, leading to postpartum neonatal abstinence syndrome. Despite their use during pregnancy, little is known about the cellular changes brought about by these drugs in the placenta...
December 14, 2016: Molecular Pharmacology
https://www.readbyqxmd.com/read/27926654/neonatal-abstinence-syndrome-and-ethical-approaches-to-the-identification-of-pregnant-women-who-use-drugs
#7
Mishka Terplan, Howard Minkoff
The United States is experiencing an epidemic of opioid use, addiction, and neonatal abstinence syndrome. Consequentially, a great deal of public, and public health, attention has turned toward the timely recognition of pregnant women who use drugs. We explore the clinical efficacy and ethical acceptability of different methods of identification-contrasting drug testing (using biologic samples such as urine) with screening (using an instrument or questionnaire) under both universal and selective approaches within the current legal and social landscape, which is fraught with potential adverse consequences for both the woman and her child...
January 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27920946/insights-in-public-health-substance-use-in-pregnant-women-in-hawai-i-extending-our-capacity-and-compassion
#8
Rebecca Delafield, Tricia E Wright
Substance use can have serious consequences for the health and well-being of individuals. The problem is of particular concern when it involves pregnant women due to health risks for the mother and the fetus. In utero exposure to either legal (eg, alcohol, cigarettes, and certain prescription drugs) or illicit (eg, amphetamines, cocaine, and opioids) substances can result in potentially serious and long-lasting health problems for infants. Available data from Hawai'i indicate that substance use among pregnant women is higher than national targets, which reflect the fact that there is essentially no acceptable rate of use of these substances...
November 2016: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/27891271/intrahepatic-cholestasis-of-pregnancy-with-severe-elevation-of-bile-acids-in-the-setting-of-acute-hepatitis-c-infection
#9
Megan L Lawlor, Agatha S Critchfield
Intrahepatic cholestasis of pregnancy (ICP) is a complication of pregnancy resulting in elevation of serum bile acid levels. ICP is often associated with underlying liver disease, including hepatitis C. Bile acids in relationship to the acute infection of hepatitis C virus have not yet been delineated in the literature. A 26-year-old gravida 4 para 2103 with dichorionic, diamniotic twin gestation and history of intravenous drug abuse developed ICP in the setting of acute hepatitis C infection. In addition to clinical symptoms of pruritus and right upper quadrant pain, she developed severe elevation in bile acids, 239 micromol/L, and transaminitis aspartate aminotransferase 1033 U/L, and alanine aminotransferase 448 U/L...
2016: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27886650/the-relationship-between-gestational-age-and-the-severity-of-neonatal-abstinence-syndrome
#10
Kelly S Gibson, Ms Sydney Stark, Deepak Kumar, Jennifer L Bailit
BACKGROUND AND AIMS: The relationship between gestational age at delivery and the severity of neonatal abstinence syndrome (NAS) is poorly understood. Our objective was to compare the length of pharmacotherapy and hospital stay among opioid exposed infants born during the late preterm, early term, full term, and late term periods. DESIGN: Retrospective cohort study of infants affected by NAS SETTING: MetroHealth Medical Center in Cleveland, Ohio, USA: an urban tertiary care hospital serving as the referral center for opioid dependency in pregnancy with a level III neonatal intensive care unit PARTICIPANTS: All deliveries complicated by maternal opioid exposure from January 2000 to October 2014; 403 were eligible to be included (n = 102 Late Preterm, 34-36weeks (LP), n = 158 Early Term, 37-38weeks (ET), n = 122 Full Term, 39-40weeks (FT), n = 21 Late Term, ≥41 weeks (LT))...
November 25, 2016: Addiction
https://www.readbyqxmd.com/read/27876117/neonatal-abstinence-syndrome-and-the-gastrointestinal-tract
#11
Denise Maguire, Maureen Gröer
Development of a healthy gut microbiome is essential in newborns to establish immunity and protection from pathogens. Recent studies suggest that infants who develop dysbiosis may be at risk for lifelong adverse health consequences. Exposure to opioid drugs during pregnancy is a factor of potential importance for microbiome health that has not yet been investigated. Since these infants are born after an entire gestation exposed to mu opioid receptor agonists and have severe gastrointestinal and neurological symptoms, we hypothesize that these infants are at risk for dysbiosis...
December 2016: Medical Hypotheses
https://www.readbyqxmd.com/read/27871180/prescription-opioid-prescribing-use-misuse-harms-and-treatment-among-aboriginal-people-in-canada-a-narrative-review-of-available-data-and-indicators
#12
Cayley Russell, Michelle Firestone, Len Kelly, Christopher Mushquash, Benedikt Fischer
INTRODUCTION: Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated problems among Aboriginal groups, no comprehensive data review currently exists. METHODS: A review of available data sources (ie journal publications, public reports and 'grey' literature) was conducted following principles of a scoping review...
October 2016: Rural and Remote Health
https://www.readbyqxmd.com/read/27824771/maternal-deaths-from-suicide-and-overdose-in-colorado-2004-2012
#13
Torri D Metz, Polina Rovner, M Camille Hoffman, Amanda A Allshouse, Krista M Beckwith, Ingrid A Binswanger
OBJECTIVE: To ascertain demographic and clinical characteristics of maternal deaths from self-harm (accidental overdose or suicide) to identify opportunities for prevention. METHODS: We report a case series of pregnancy-associated deaths resulting from self-harm in the state of Colorado between 2004 and 2012. Self-harm deaths were identified from several sources, including death certificates. Birth and death certificates along with coroner, prenatal care, and delivery hospitalization records were abstracted...
December 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27816920/preconception-use-of-pain-relievers-and-time-to-pregnancy-a-prospective-cohort-study
#14
Kathryn A McInerney, Elizabeth E Hatch, Amelia K Wesselink, Kenneth J Rothman, Ellen M Mikkelsen, Lauren A Wise
STUDY QUESTION: To what extent is preconception use of pain-relieving medication associated with female fecundability? SUMMARY ANSWER: Women who used naproxen or opioids had slightly lower fecundability than women who did not use any pain-relieving medications; use of acetaminophen, aspirin and ibuprofen was not appreciably associated with fecundability. WHAT IS KNOWN ALREADY: Over-the-counter pain-relieving medications are commonly used by women of reproductive age in the USA...
January 2017: Human Reproduction
https://www.readbyqxmd.com/read/27807736/-analgesic-drugs-during-pregnancy
#15
S Hultzsch, C Schaefer
Some important limitations must be taken into consideration for analgesic therapy during pregnancy. Paracetamol is the agent of choice for mild to moderate pain in any stage of pregnancy. Ibuprofen is the non-steroidal anti-inflammatory drug (NSAID) of choice; however, these substances are contraindicated after 28 weeks of gestation due to the increasing risk of premature closure of the ductus arteriosus and impairment of fetal kidney function. Even opioids can be used for severe pain but peripartum administration can lead to neonatal respiratory depression and adaptation disorders and long-term therapy up to the end of pregnancy can lead to neonatal withdrawal symptoms...
November 2, 2016: Der Schmerz
https://www.readbyqxmd.com/read/27799240/observational-study-of-the-safety-of-buprenorphine-naloxone-in-pregnancy-in-a-rural-and-remote-population
#16
Naana Afua Jumah, Craig Edwards, Jazmyn Balfour-Boehm, Kassandra Loewen, Joseph Dooley, Lianne Gerber Finn, Len Kelly
OBJECTIVES: To describe the effect of in utero exposure to the buprenorphine+naloxone combination product in a rural and remote population. SETTING: A district hospital that services rural and remote, fly-in communities in Northwestern Ontario, Canada. PARTICIPANTS: A retrospective cohort study was conducted of 855 mother infant dyads between 1 July 2013 and 30 June 2015. Cases included all women who had exposure to buprenorphine+naloxone during pregnancy (n=62)...
October 31, 2016: BMJ Open
https://www.readbyqxmd.com/read/27776056/opioid-use-disorder-in-pregnancy-health-policy-and-practice-in-the-midst-of-an-epidemic
#17
Robert D Stewart, David B Nelson, Jodi S Dashe, George D Wendel
No abstract text is available yet for this article.
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27776054/opioid-use-disorder-in-pregnancy-health-policy-and-practice-in-the-midst-of-an-epidemic
#18
Ashish Premkumar, Mishka Terplan
No abstract text is available yet for this article.
November 2016: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27773527/a-moral-or-medical-problem-the-relationship-between-legal-penalties-and-treatment-practices-for-opioid-use-disorders-in-pregnant-women
#19
Cara Angelotta, Carol J Weiss, John W Angelotta, Richard A Friedman
OBJECTIVE: The relationship between use of medication-assisted treatment (MAT) in pregnant women with opioid use disorders, the standard of care, and state laws that permit child abuse charges for illicit drug use during pregnancy has not been described. METHODS: Using publicly available data on substance abuse treatment in the United States, we describe patterns in the use of MAT for pregnant women with opioid use disorders in states with prenatal child abuse laws compared with states without such laws...
October 20, 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/27743517/a-unique-opportunity-to-study-short-and-long-term-consequences-in-children-prenatally-exposed-to-illicit-drugs-and-opioid-maintenance-treatment-using-czech-and-scandinavian-registers
#20
Roman Gabrhelík, Blanka Nechanská, Viktor Mravčík, Svetlana Skurtveit, Ingunn Olea Lund, Marte Handal
Licit and illicit drug use in pregnant women constitutes a long lasting and serious problem worldwide. Information on long-term effects of maternal drug use on the child is limited. Nationwide registers provide a great potential to study short and long-term consequences for children exposed to licit and illicit drugs during pregnancy. We discuss this potential, with a special emphasis on exposure to methamphetamine, heroin and prescription drugs used for opioid maintenance treatment (OMT). We also discuss the advantages of register data and of merging such data from different regions...
September 2016: Central European Journal of Public Health
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