CHERI HOGSTEN

LAURIE MARCELLOKRISTA LAWS

ERINN MATTHEWSSTEPHANIEJENNIFER

Drugs and Alcohol in Pregnancy

LPN 105 – Group 4

November 7, 2011

Drugs and Alcohol in Pregnancy

Overview: Drugs and alcohol can be harmful during any

stage of pregnancy both prescription and non prescription. However, fetal harm is of the greatest concern during the first trimester when the earliest development is critical. Unfortunately, a woman may not be aware of their pregnancy at this stage. Both drugs and alcohol cross the placenta with similar complications. Many women who abuse one drug have the additional problem of abusing more than one at the same time doubly increasing the risks to the pregnancy.

Signs and Symptoms: Pregnancy and Effect on Infant

Risk of premature birth and miscarriage Low birth weight, hypoglycemia and

intercranial hemorrhage Babies may have failure to thrive or grow

at normal rates after birth.

Alcohol - Characteristics

Leading known cause of birth defects Risk of miscarriage doubles Average birth weight of babies is about 4

lbs for babies exposed to large amounts of alcohol

Can cause malformations especially in the first ten weeks

Problems with heart, limbs, and facial features in baby are indicative of Fetal Alcohol Syndrome

Fetal Alcohol Syndrome

S&S: Small skull, Abnormal facial features, Heart defects, Impeded growth, Mental retardation.

Simple eye movement test on infant used to diagnoseHighest risk for FAS is binge drinking

Drugs and Tobacco Usage………..,

Facts S&S

underweight

withdrawal

Birth defects

4% of pregnant women

Crossing placenta

Tobacco 

S&S: Placenta preveia, abrution placentae, preterm labor, miscarriage and still births Even secondhand smoke should be avoided. Only about 20% of women who smoke quit during pregnancy.

Passes nicotine and cancer causing agents to fetus Increases risk of SIDS Only about 20% of women who smoke quit during

pregnancy Inhibits fetal growth Depresses woman’s appetite and possibly

depriving nutrition to fetus Reduces the ability of the lungs to absorb oxygen

and possibly depriving some oxygen to the fetus. However, studies indicate the body does compensate for these losses by forcing the hemoglobin to carry more oxygen.

SPECIFIC DRUGS AND THEIR UNIQUE ADDITIONAL EFFECTS:

Marijuana, Cocaine and Meth, Heroin, PCP LSD

MARIJUANA

Contains toxins like tobacco inhibiting oxygen supply

Occasional use during the 1st trimester is unlikely to cause birth defects.

COCAINE AND METH

If used especially in later pregnancy an infant experiences profound withdrawal, sleepnessness, difficulty feeding and muscle spasms. Defects of genitals, kidneys and brain are possible with early pregnancy use.Learning difficulties often prevail throughout childhood.

Heroin

Withdrawal symptoms in these infants is the most profound than any other drug.

Infant death is more common than with any other drug.

More likelihood of HIV infection in infant as Heroin is often injected

PCP LSD

Brain damage Birth defects

Prevention

Educate,Educateeducate!

If a woman anticipates becoming pregnant then a health care provider’s best approach is to educate women of child bearing age to:

 Stop smoking. Do not drink alcohol. Do not use illegal drugs.

Treatment and Nursing CareTreatment options for pregnant women who are drug addicted: Do’s and

Dont’s

DO’S DONT’S

Safe, confidential pregnancy detox for drug addiction is available via substance abuse treatment centers.

Psychiatric and obsteteric evaluation and care are primary venues for women to seek treatment and/or referrals.

No sudden detox for drug addicted mothers

Even secondhand tobacco smoke should be avoided.

Types of Drugs used for Chemical Detox

Methadone, Buprenorphine and Naltrexon are used for controlled medical detox.There are few supported studies on long term effects but, clearly preferable to drug abuse.

Nursing Care and Interventions should include:

Again - supportive non judgmental care.Use referrals to available resources to assist women.Keep in mind that these mothers are fearful of many factors including losing custody of other children, incarceration or criminal charges and, at the very least embarassment.

LawsCurrently no states hold prenatal substance abuse as a criminal act of child abuse and neglect. However, many states have expanded child welfare requirements to include substance abuse during pregnancy as grounds for termination of parental rights.

Presentation Contributors

Resources

http://www.nsnet.org/nsfas/symptoms.html