Document Detail


Opioid addiction in pregnancy.
MedLine Citation:
PMID:  23233054     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
SUMMARY: Opioid dependence in pregnancy carries clear identifiable maternal and fetal risk. Providing care for patients with dependence is best done in a multidisciplinary care model addressing the particular needs of this population. There are limited data on maternal detoxification, with data still emerging surrounding the safety profile of this practice. Historically, methadone has been the recommended maintenance treatment; however, recent data on buprenorphine identify this as a safe and effective option. The majority of births from women with opioid dependence result in neonatal abstinence syndrome requiring prolonged neonatal hospitalization. Intrapartum pain management should not differ from the general obstetric population. Postpartum pain is magnified in this population, and particular attention should be focused on this issue. Breast-feeding is recommended regardless of maintenance dose, unless other conditions restricting breast-feeding are present. Comprehensive postpartum care and transition of care to addiction specialists are highly recommended.
TARGET AUDIENCE: Obstetricians and gynecologists, family physicians, addiction specialists.
LEARNING OBJECTIVES: After completing this CME activity, physicians should be better able to assess the treatment options available to patients with opioid addiction during pregnancy, compare the risk/safety profiles of methadone and buprenorphine, and evaluate the recommendations and current data surrounding breast-feeding while on opioid maintenance treatment.
Authors:
Scott A Shainker; Kelley Saia; Aviva Lee-Parritz
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Obstetrical & gynecological survey     Volume:  67     ISSN:  1533-9866     ISO Abbreviation:  Obstet Gynecol Surv     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-12     Completed Date:  2013-06-10     Revised Date:  2014-07-31    
Medline Journal Info:
Nlm Unique ID:  0401007     Medline TA:  Obstet Gynecol Surv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  817-25     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Analgesics, Opioid / therapeutic use
Breast Feeding
Buprenorphine / therapeutic use
Female
Humans
Infant, Newborn
Methadone / therapeutic use
Neonatal Abstinence Syndrome / etiology*
Opiate Substitution Treatment
Opioid-Related Disorders / complications,  drug therapy*
Pain Management
Pregnancy
Pregnancy Complications / drug therapy*
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 40D3SCR4GZ/Buprenorphine; UC6VBE7V1Z/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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