Pregnancy, birth, and puerperium in women suffering from heroin addiction

Abstract

The increase in the number of drug addicts presents obstetricians and pediatricians with a growing problem. In spite of the endocrine disturbances caused by drugs, pregnancies do occur in addicts and they present increased risks of such complications as hepatitis, malnutrition, veneral disease, phlebitis, and abscesses; intra-uterine death, premature rupture of the membranes, malpresentation, distocia, and small-for-date babies are likely. Above all, there are numerous social and psychological problems. Because black market heroin is extremely variable in strength, the fetus can face the alternative risks of maternal overdose or withdrawal. During the latter, strong fetal movements increase oxygen consumption leading to fetal anoxia and possible death. The newborn babies of addicted mothers often develop a withdrawal syndrome within a variable period after birth. The symptoms are sneezing, extreme restlessness, shrill crying, tremor and fasciculation, tachycardia, fluid loss from sweating, polyuria and diarrhoea, fever, and generalized cramps.