Substance Abuse During Pregnancy An Issue Of Obstetrics And Gynecology Clinics

This issue of Obstetrics and Gynecology Clinics of North America deals with the timely subject of substance use during pregnancy. Alcohol, tobacco, and illicit drug use is prevalent among reproductive-age women. Even though a reduction in use often occurs during pregnancy, many women continue to use substances until a pregnancy is either actually diagnosed or well underway.This issue consists of a well-qualified team of obstetricians-gynecologists, psychiatrists, and family physicians, focusing on various issues related directly to pregnancies complicated by substance use. Topics of interest include epidemiology and screening for hazardous and harmful substance use, teratogenic risks, psychiatric comorbidities, comprehensive treatment approaches before and after delivery, fetal surveillance, and team-based perinatal management. Particularly new information relates to prescribing buprenorphine, neonatal abstinence syndrome, and adolescent substance use.

This issue of Obstetrics and Gynecology Clinics of North America deals with the timely subject of substance use during pregnancy. Alcohol, tobacco, and illicit drug use is prevalent among reproductive-age women. Even though a reduction in use often occurs during pregnancy, many women continue to use substances until a pregnancy is either actually diagnosed or well underway.This issue consists of a well-qualified team of obstetricians-gynecologists, psychiatrists, and family physicians, focusing on various issues related directly to pregnancies complicated by substance use. Topics of interest include epidemiology and screening for hazardous and harmful substance use, teratogenic risks, psychiatric comorbidities, comprehensive treatment approaches before and after delivery, fetal surveillance, and team-based perinatal management. Particularly new information relates to prescribing buprenorphine, neonatal abstinence syndrome, and adolescent substance use.

Patients often try to conceal or understate their alcohol and illicit drug use; this also applies to mothers attending antenatal clinics. Questions about substance abuse should be direct in the attempt to create an open and confidential atmosphere. A pregnancy in a woman with substance abuse problems is always a high-risk pregnancy, and these women should be referred to a specialist substance abuse antenatal clinic as early as possible. Appropriate substance abuse treatment for a pregnant woman should be initiated without delay and with her consent.

The Guest Editors have assembled expert authors to provide current clinical views and recommendations for patients with medical disorders in pregnancy. Clinical reviews are devoted to the following topics: Obstructive sleep apnea in pregnancy; Pregestational Diabetes; Gestational Diabetes; Maternal mortality in the 21 century; Infections in pregnancy and the role of vaccines; Peripartum cardiomyopathy; Update on HIV in pregnancy: Thromboprophylaxis; Opiate abuse in pregnancy.

In this issue of Obstetrics and Gynecology Clinics of North America, guest editor Dr. Catherine Stika brings her considerable expertise to the topic of Drugs in Pregnancy. The use of medications during pregnancy can be difficult to manage because not only is research lagging in this area, but typically drugs are not studied for use in pregnant women. In this issue, key experts provide a state-of-the-art review on clinical pharmacology in pregnancy, with a look at commonly prescribed medications as well as over-the-counter medications. Contains 17 practice-oriented topics including obstetrical pharmacology; over-the-counter medications in pregnancy; antibiotic use in pregnancy; opioids in pregnancy; mood disorder medications in pregnancy; and more. Provides in-depth clinical reviews on drugs in pregnancy, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

These guidelines have been developed to enable professionals to assist women who are pregnant, or have recently had a child, and who use alcohol or drugs or who have a substance use disorder, to achieve healthy outcomes for themselves and their fetus or infant. They have been developed in response to requests from organizations, institutions and individuals for technical guidance on the identification and management of alcohol, and other substance use and substance use disorders in pregnant women. They were developed in tandem with the WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy.

This issue of Obstetrics and Gynecology Clinics of North America provides a summary of several more common maternal-fetal-infant infectious diseases. Several experts in the field of maternal and perinatal infection have contributed to this issue to provide an overview of the up-to-date preventive strategies, screening and diagnostic methods, and treatment guidelines. While guidelines such as universal vaccination to prevent influenza during pregnancy are fairly well justified by supporting data, there is much uncertainty about the appropriate screening guidelines for conditions such as cytomegalovirus, where the lack of a proven effective treatment diminishes the value of screening. Moreover, increasing issues of antibiotic resistance and the lack of significant advancement in developing newer effective agents imply that both providers and health care facilities must follow guidelines of antimicrobial stewardship (ie, coordinated efforts to improve and measure the appropriate use of antimicrobials). It is our hope that this issue will aid providers in navigating these complex issues while also understanding the current state-of-the-science