In this protocol, Terplan reviews screening for substance use and diagnosis and management of addiction during pregnancy, labor and delivery, and postpartum. The information is presented against the backdrop of the current opioid crisis. Tables on medication choice and protocols and on risk and protective factors for neonatal abstinence syndrome (NAS) are included.
Protocols for High-Risk Pregnancies, 7th Edition
As the authors note, today about 50% of heroin users are female, versus less than 20% in the 1970s. At least half of those who present for treatment of opioid use disorder (OUD) are female. Between 1999 and 2014, rates of OUD at delivery and of NAS more than quadrupled. Yet the need for treatment is largely unmet, with only 30% to 70% of pregnant women with opioid addiction reportedly receiving care for it during pregnancy.
READ the complete chapter on opioids in pregnancy and postpartum from Protocols for High-Risk Pregnancies, 7th Edition, edited by John T. Queenan, MD, Catherine Y. Spong, MD, and Charles J. Lockwood, MD, MHCM, now.