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PPO.64 A pilot analysis of the obstetric and foetal risks observed in a specialist clinic for pregnant women who disclosed substance misuse
  1. J Obeney-Williams1,
  2. A Azhar2,
  3. A Wright2,
  4. J Bayly2,
  5. M Theron2,
  6. N Turjanski1
  1. 1Camden and Islington Mental Helath Trust, London, UK
  2. 2Royal Free Hospital, London, UK

Abstract

Aim Studies have shownsubstance abuse among pregnant women can cause intra uterine growth retardation[4] (IUGR) Pregnant women disclosing substance misuse before or during pregnancy were intensively monitored and this pilot represents the last six months of data.

Methods Women were asked about alcohol and drug use at booking both before and during pregnancy. Outcomes analysed were obstetric complications, mode and gestation of delivery, birth weights, and treatment in SCBU.

Results Eight of the nine booked in the first trimester.

None had pre-existing medical conditions.

No women had a diagnosis of severe and enduring psychiatric illness.

Four used alcohol before or during pregnancy, two used a variety of drugs including Heroin, Cocaine, and Ketamine. Two took opiate replacement therapy and three used cannabis.

There were three pre-term deliveries (32–35 weeks) including one elective C-section and one urgent C-section.

Of the term deliveries four were induced for IUGR.

There were only two Spontaneous vaginal deliveries whose neonates were born at term and did not have IUGR.

Five neonates were below 10th Centile for weight.

Two women had hypertension of pregnancy and one had polyhydramnios, requiring fluid drainage during pregnancy.

Four babies needed SCBU, two for opiate replacement and one (with facial dysmorphia) required ventilation.

Conclusions The results suggest a higher than expected rate of IUGR and pre-term and interventional delivery.

In our view, this highlights the additional risks to pregnant women who use substances, possibly resulting from poor nutrition and chaotic lifestyles. despite booking early, and engaging with ante-natal care.

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