Impact Of Maternal Opioid Use On Fetal Welfare

Opioid dependence in the pregnant woman is not only overwhelming to her own physical condition but also dangerous to that of the fetus (and eventually to the newborn infant). Because of her lifestyle, and because she may fear calling attention to her drug habit, the pregnant addict often does not seek prenatal care. Obstetrical complications associated with heroin addiction include miscarriages, premature separation of the placenta, infection of the membranes surrounding the FETUS, stillbirth, retardation of the growth of the fetus, and premature labor.

Because no quality control exists for street drugs, doses and substances used to stretch the dose may cause repeated episodes of underdose, withdrawal, and/or overdose. Maternal narcotic withdrawal has been associated with the occurrence of stillbirth. Severe withdrawal is associated with increased muscular activity, thereby increasing the rates of metabolism and oxygen consumption; during maternal withdrawal, fetal activity also increases, as does the oxygen need of the fetus. The oxygen reserve in the placenta may not be able to supply the extra oxygen needed by the fetus. During labor, contractions further inhibit the blood flow through the uterus. If labor coincides with withdrawal symptoms in the mother, the fetus will also withdraw. Since uterine blood flow will vary at this time, and less oxygen will be delivered to the fetus, fetal death may occur.

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