PPO.64 A pilot analysis of the obstetric and foetal risks observed in a specialist clinic for pregnant women who disclosed substance misuse

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Abstract

Aim

Studies have shownsubstance abuse among pregnant women can cause intra uterine growth retardation[4] (IUGR) Pregnant women disclosing substance misuse before or during pregnancy were intensively monitored and this pilot represents the last six months of data.

Methods

Women were asked about alcohol and drug use at booking both before and during pregnancy. Outcomes analysed were obstetric complications, mode and gestation of delivery, birth weights, and treatment in SCBU.

Results

Eight of the nine booked in the first trimester.

Results

None had pre-existing medical conditions.

Results

No women had a diagnosis of severe and enduring psychiatric illness.

Results

Four used alcohol before or during pregnancy, two used a variety of drugs including Heroin, Cocaine, and Ketamine. Two took opiate replacement therapy and three used cannabis.

Results

There were three pre-term deliveries (32–35 weeks) including one elective C-section and one urgent C-section.

Results

Of the term deliveries four were induced for IUGR.

Results

There were only two Spontaneous vaginal deliveries whose neonates were born at term and did not have IUGR.

Results

Five neonates were below 10th Centile for weight.

Results

Two women had hypertension of pregnancy and one had polyhydramnios, requiring fluid drainage during pregnancy.

Results

Four babies needed SCBU, two for opiate replacement and one (with facial dysmorphia) required ventilation.

Conclusions

The results suggest a higher than expected rate of IUGR and pre-term and interventional delivery.

Conclusions

In our view, this highlights the additional risks to pregnant women who use substances, possibly resulting from poor nutrition and chaotic lifestyles. despite booking early, and engaging with ante-natal care.

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