Materno-fetal impact of drug abuse during pregnancy
L. Pleș, R.M. Sima, D. Carp, A. Rîcu, M.O. Poenaru, A.D. Stănescu
Rezumat: Introduction. The consumption of illicit substances is a
global problem through its medical, economic and social
implications. The implications in pregnancy are important
in the last decades, and have become an aspect that we
meet in obstetric practice in Romania. Material and
methods. We realized a retrospective study in which we
assessed patients that gave birth at the “Bucur” Maternity
between January 2011 and January 2015 and were drug
users. The status of drug user was established on the
statements of pregnant women. The analysis was carried
out by consulting the DRG system. Results. According
to DRG coding, we identified 15 cases of pregnant drug
users. The possibility of underdiagnosis exists due to
several factors: a lack of codification in electronic systems
justified by the absence of clear codes; the impossibility
of carrying out laboratory investigations to identify the
illicit drug, the nonrecognition by some patients of this
condition. Among patients, it was noticed that most of
them had consumed heroin (56.4%), cocaine (14.7%) and
marijuana (28.9%). Only one patient had proper prenatal
care, being in substitution treatment with methadone.
The associations between drug abuse and maternal
infectious were represented by chronic hepatitis HCV,
HBV, syphilis and HIV. Regarding fetal consequences, we
identified a case of anencefal fetus born at term, 3,500
g, resulted from a heroin-consumer mother without
any prenatal care. Four newborns with withdrawal
syndrome were registered, but the majority (74.3%) had
a favorable outcome. Eleven newborns were abandoned
after birth. Conclusions. Drug use in pregnancy is
associated with pregnancies without prenatal care,
with infectious pathologies and a difficult approach at
birth (i.e., the impossibility of obtaining venous access,
difficult patients to deal with). The withdrawal syndrome
among fetuses and fetal abandonment is common. Cuvinte cheie: heroin, withdrawal syndrome, methadone.