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Drugs, Alcohol, Pregnancy, and the Fetal Alcohol Syndrome

Obstetrical patients are not immune from the rampant epidemic of substance abuse of both legal and illegal substances with no medical usage. Substance abuse in pregnancy has increased over the past 3 decades, resulting in approximately 225,000 infants yearly with prenatal exposure. Totally one half of all pregnant patients admitted to abusing alcohol or other substances including tobacco during their pregnancy in 1 study. Poor obstetric outcomes can be up to 6 times higher in patients using opiates and neonatal care must be specialized to treat symptoms of withdrawal in mother and baby. The incidence of preterm labor, placental abruption, spontaneous abortion, and congenital anomalies are all increased. The anesthesiologist will invariably deal with the substance addicted or abusing parturient during his or her career.