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Opioid use and pregnancy

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https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#1
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29769809/managing-infants-born-to-mothers-who-have-used-opioids-during-pregnancy
#2
Thierry Lacaze-Masmonteil, Pat O'Flaherty
The incidence of infant opioid withdrawal has grown rapidly in many countries, including Canada, in the last decade, presenting significant health and early brain development concerns. Increased prenatal exposure to opioids reflects rising prescription opioid use as well as the presence of both illegal opiates and opioid-substitution therapies. Infants are at high risk for experiencing symptoms of abstinence or withdrawal that may require assessment and treatment. This practice point focuses specifically on the effect(s) of opioid withdrawal and current management strategies in the care of infants born to mothers with opioid dependency...
May 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29760859/substance-use-in-pregnant-women-using-the-emergency-department-undertested-and-overlooked
#3
C Leigh Moyer, Sean Johnson, Marilyn G Klug, Larry Burd
Introduction: The objective was to determine if pregnant women visiting the emergency department (ED) are tested for substance use as frequently as non-pregnant women. Methods: We captured all ED visits over a six-year period (2010-2016) from a single community hospital and identified women of childbearing age, defined for our study as 11-50 years old. We collected demographic data including age in years, ethnicity, body mass index, marital status, disposition, last encounter department, method of arrival, and day of week...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29747726/opioid-use-disorders-and-pregnancy
#4
REVIEW
Amanda J Johnson, Cresta W Jones
Opioid use disorder presents an increased risk of complications in pregnancy, particularly when untreated. To optimize outcomes, medication-assisted treatment using methadone or buprenorphine as a part of a comprehensive care model is recommended. Neonatal abstinence syndrome and poor fetal growth remain significant complications of this disorder despite maternal treatment.
June 2018: Obstetrics and Gynecology Clinics of North America
https://www.readbyqxmd.com/read/29744859/prescription-opioid-use-in-pregnancy
#5
REVIEW
Julie Blandthorn, Laura Leung, Yuan Loke, D Martyn Lloyd-Jones, Robin Thurman, Ellen Bowman, Yvonne Bonomo
Prescription medications, including opioid analgesics, are increasingly prescribed in Australia and internationally. More women are presenting in pregnancy with prescription opioid use which can potentially cause harm to the mother and fetus. This article outlines the different types of prescription opioids, defines how prescription opioid use disorder presents clinically and suggests a rational clinical approach to assess and manage patients in the context of pregnancy and their infants.
May 10, 2018: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29720535/hepatitis-c-virus-screening-among-children-exposed-during-pregnancy
#6
Catherine A Chappell, Sharon L Hillier, David Crowe, Leslie A Meyn, Debra L Bogen, Elizabeth E Krans
OBJECTIVES: Because of the opioid epidemic, hepatitis C virus (HCV) infection is increasing among pregnant women, resulting in an increased risk of perinatal transmission and HCV infection among children. Our primary objectives in this study were to determine the prevalence of HCV among pregnant women and the frequency of pediatric HCV screening. METHODS: A population-based, retrospective cohort of pregnant women who delivered between 2006 and 2014 was identified and classified as HCV infected or HCV uninfected by billing codes...
May 2, 2018: Pediatrics
https://www.readbyqxmd.com/read/29704852/prevalence-of-alcohol-use-in-pregnant-women-with-substance-use-disorder
#7
Ludmila N Bakhireva, Shikhar Shrestha, Laura Garrison, Lawrence Leeman, William F Rayburn, Julia M Stephen
BACKGROUND: Prenatal care programs for women with opioid use disorder (OUD) often focus treatment/counseling plans around illicit substances, while concurrent use of alcohol might present an equal or greater risk to the fetus. METHODS: This study evaluated self-reported prevalence of alcohol use in patients participating in a comprehensive prenatal care program for women with substance use disorder (SUD; n = 295), of which 95% are treated for OUD, and pregnant women being served through general obstetrical clinics at the University of New Mexico (n = 365)...
June 1, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29692634/chronic-pain-during-pregnancy-a-review-of-the-literature
#8
REVIEW
Shona L Ray-Griffith, Michael P Wendel, Zachary N Stowe, Everett F Magann
Background and purpose: The majority of the reviews and studies on chronic pain in pregnancy have primarily focused on the pharmacological and non-pharmacological treatment options. The purpose of our review was to identify evidence-based clinical research for the evaluation and management of preexisting chronic pain in pregnancy, chronic pain associated with pregnancy, and chronic pain in relation to mode of delivery. Methods: A literature search was undertaken using the search engines PubMed, CINAHL, EBSCOhost, and Web of Science...
2018: International Journal of Women's Health
https://www.readbyqxmd.com/read/29651928/rural-postpartum-women-with-substance-use-disorders
#9
Debra Kramlich, Rebecca Kronk, Lenora Marcellus, Alison Colbert, Karen Jakub
The incidence of perinatal opioid use and neonatal withdrawal continues to rise rapidly in the face of the growing opioid addiction epidemic in the United States, with rural areas more severely affected. Despite decades of research and development of practice guidelines, maternal and neonatal outcomes have not improved substantially. This focused ethnography sought to understand the experience of accessing care necessary for substance use disorder recovery, pregnancy, and parenting. Personal accounts of 13 rural women, supplemented by participant observation and media artifacts, uncovered three domains with underlying themes: challenges of getting treatment and care (service availability, distance/geographic location, transportation, provider collaboration/coordination, physical and emotional safety), opportunities to bond (proximity, information), and importance of relationships (respect, empathy, familiarity, inclusion, interactions with care providers)...
April 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29643617/comparison-of-ropivacaine-0-2-with-or-without-clonidine-1-%C3%AE-g-kg-for-epidural-labor-analgesia-a-randomized-controlled-study
#10
Indira Kumari, Kapil Sharma, Vikram Bedi, Madhan Mohan, Hemraj Tungaria, Manish Kumar Modi
Background and Aims: The aim is to determine the effect of addition of clonidine to ropivacaine for epidural labor analgesia with regard to onset of analgesia, duration of analgesia, neonatal outcome, and quality of analgesia. Material and Methods: A total of 60 term parturients of the American Society of Anesthesiologists Grade I and II with uncomplicated pregnancy, vertex presentation, posted for on-demand epidural labor analgesia after informed consent were divided in two groups...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29630018/prescription-and-other-medication-use-in-pregnancy
#11
David M Haas, Derek J Marsh, Danny T Dang, Corette B Parker, Deborah A Wing, Hyagriv N Simhan, William A Grobman, Brian M Mercer, Robert M Silver, Matthew K Hoffman, Samuel Parry, Jay D Iams, Steve N Caritis, Ronald J Wapner, M Sean Esplin, Michal A Elovitz, Alan M Peaceman, Judith Chung, George R Saade, Uma M Reddy
OBJECTIVE: To characterize prescription and other medication use in a geographically and ethnically diverse cohort of women in their first pregnancy. METHODS: In a prospective, longitudinal cohort study of nulliparous women followed through pregnancy from the first trimester, medication use was chronicled longitudinally throughout pregnancy. Structured questions and aids were used to capture all medications taken as well as reasons they were taken. Total counts of all medications taken including number in each category and class were captured...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29630016/opioid-detoxification-during-pregnancy-a-systematic-review
#12
Mishka Terplan, Hollis J Laird, Dennis J Hand, Tricia E Wright, Ashish Premkumar, Caitlin E Martin, Marjorie C Meyer, Hendrée E Jones, Elizabeth E Krans
OBJECTIVE: To systematically review maternal and neonatal outcomes associated with opioid detoxification during pregnancy. DATA SOURCES: PubMed, PsycINFO, EMBASE, Cochrane, and ClinicalTrials.gov databases were searched from January 1, 1966, to September 1, 2016. METHODS OF STUDY SELECTION: English-language studies that reported outcomes associated with opioid detoxification among pregnant women with opioid use disorder were included. Nonoriginal research articles (case reports, editorials, reviews) and studies that failed to report outcomes for detoxification participants were excluded...
May 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29610676/pregnant-or-recently-pregnant-opioid-users-contraception-decisions-perceptions-and-preferences
#13
Rebecca L Fischbein, Bethany G Lanese, Lynn Falletta, Kelsey Hamilton, Jennifer A King, Deric R Kenne
Background: Multiple factors are linked to extremely high unintended pregnancy rates among women who use opioids, including various barriers to contraception adherence. These include patient level barriers such as lack of knowledge and education about highly effective contraception, and potential provider barriers. Using a mixed-methods framework to examine the contraception-related perceptions and preferences of opioid using women is a necessary next step to understanding this phenomenon...
2018: Contraception and reproductive medicine
https://www.readbyqxmd.com/read/29601303/the-opioid-epidemic-and-pregnancy-implications-for-anesthetic-care
#14
Britany L Raymond, Bradley T Kook, Michael G Richardson
PURPOSE OF REVIEW: This review summarizes evolving knowledge regarding adverse maternal, fetal, and neonatal effects of opioid exposure during pregnancy, and current treatment options for opioid use disorder (OUD). Maternal and fetal implications of maternal opioid maintenance with methadone and buprenorphine are described. Finally, acute and chronic pain management strategies in opioid-tolerant parturients are reviewed. RECENT FINDINGS: Opioid use among parturients has risen dramatically, with opioid use during pregnancy as high as 20%...
March 29, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29580450/opioid-utilization-by-pregnant-women-with-sickle-cell-disease-and-the-risk-of-neonatal-abstinence-syndrome
#15
Aisha Nnoli, Neil S Seligman, Kevin Dysart, Jason K Baxter, Samir K Ballas
BACKGROUND: Pregnant women with sickle cell disease (SCD) are at increased risk of maternal and fetal complications. There are limited data on the outcome of the treatment of VOCs with opioids in relation to neonatal complications during pregnancy. METHODS: This is a retrospective cohort study of women with SCD from January 1999 to December 2008. Women with SCD were identified by ICD-9 codes and matched 2:1 to a control group of women on methadone for opioid dependence...
April 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/29572587/neonatal-abstinence-syndrome-nas-in-southwestern-border-states-examining-trends-population-correlates-and-implications-for-policy
#16
Khaleel S Hussaini, Luigi F Garcia Saavedra
Introduction Neonatal abstinence syndrome (NAS) is withdrawal syndrome in newborns following birth and is primarily caused by maternal drug use during pregnancy. This study examines trends, population correlates, and policy implications of NAS in two Southwest border states. Materials and Methods A cross-sectional analysis of Hospital Inpatient Discharge Data (HIDD) was utilized to examine the incidence of NAS in the Southwest border states of Arizona (AZ) and New Mexico (NM). All inpatient hospital births in AZ and NM from January 1, 2008 through December 31, 2013 with ICD9-CM codes for NAS (779...
March 23, 2018: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/29570477/is-preconception-substance-use-associated-with-unplanned-or-poorly-timed-pregnancy
#17
Lisbet S Lundsberg, Stephanie Peglow, Neena Qasba, Kimberly A Yonkers, Aileen M Gariepy
OBJECTIVE: Unplanned and poorly timed pregnancies are associated with adverse maternal and neonatal outcomes. Further understanding of preconception substance use with unplanned and poorly timed pregnancy is warranted. METHODS: Data were analyzed from a prospective study enrolling women early in pregnancy. Preconception tobacco, alcohol, marijuana, opioid, and cocaine use was ascertained. Participants reported whether their current pregnancy was planned and whether it was a good time to be pregnant...
March 22, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29547380/maternal-opioid-use-disorder-and-neonatal-abstinence-syndrome-in-northwest-ontario-a-7-year-retrospective-analysis
#18
Joe Dooley, Gareth Ryan, Lianne Gerber Finn, Megan Bollinger, Cai-Lei Matsumoto, Wilma M Hopman, Len Kelly
INTRODUCTION: Opioid use in pregnancy is increasing globally. In northwest Ontario, rates of neonatal abstinence syndrome (NAS) are alarmingly high. We sought to document the increasing rates of opioid exposure during pregnancy and associated cases of NAS over a 7-year period in northwest Ontario. METHODS: We conducted a retrospective chart review at the Sioux Lookout Meno Ya Win Health Centre catchment area (population 29 000) maternity program in northwest Ontario of mother-infant dyads of live births from Jan...
2018: Canadian Journal of Rural Medicine
https://www.readbyqxmd.com/read/29530747/use-of-intravenous-acetaminophen-in-postoperative-pain-management-after-partial-and-full-bony-impacted-third-molar-extractions-a-randomized-double-blind-controlled-trial
#19
Isabel Atencio, Max Beushausen, John J Kowalczyk, Andres Flores-Hidalgo, Nora F Fino, Dale A Baur
PURPOSE: Currently, there is a concern at the national level of the overuse of both prescription and nonprescription opioid use. The purpose of this study was to identify whether the use of the intravenous (IV) formulation of acetaminophen (Ofirmev; Mallinckrodt Pharmaceuticals, Staines-upon-Thames, United Kingdom) is an effective tool in the reduction of postoperative pain, with a secondary goal of reduction of postoperative narcotic use. MATERIALS AND METHODS: A total of 72 patients with previously diagnosed either partial bony or complete bony impacted third molars were selected with care to avoid long-acting local anesthetics or dissociative anesthetic agents...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29527487/hypersynchrony-in-meg-spectral-amplitude-in-prospectively-identified-6-month-old-infants-prenatally-exposed-to-alcohol
#20
Julia M Stephen, Lucinda Flynn, Danielle Kabella, Megan Schendel, Sandra Cano, Daniel D Savage, William Rayburn, Lawrence M Leeman, Jean Lowe, Ludmila N Bakhireva
Early identification of children who experience developmental delays due to prenatal alcohol exposure (PAE) remains a challenge for individuals who do not exhibit facial dysmorphia. It is well-established that children with PAE may still exhibit the cognitive and behavioral difficulties, and individuals without facial dysmorphia make up the majority of individuals affected by PAE. This study employed a prospective cohort design to capture alcohol consumption patterns during pregnancy and then followed the infants to 6 months of age...
2018: NeuroImage: Clinical
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