Opioid Management in Pregnancy and Postpartum

• Published in: Obstetrics and gynecology clinics of North America Vol. 47; no. 3; pp. 421 - 427
• Main Author: Brown, Haywood L.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2020
• Subjects: Adult; Analgesics, Opioid - adverse effects; Analgesics, Opioid - therapeutic use; Buprenorphine - therapeutic use; Cesarean Section; Female; Humans; Infant, Newborn; Labor, Obstetric; Methadone - therapeutic use; Neonatal Abstinence Syndrome - epidemiology; Opiate Substitution Treatment; Opioid agonist maintenance; opioid use disorder; Opioid-Related Disorders - drug therapy; Opioid-Related Disorders - epidemiology; Pain Management - methods; Perinatal Care; Postoperative pain management; Postpartum Period; Pregnancy; Pregnancy Complications - drug therapy; Pregnancy Complications - epidemiology; Pregnancy; opioid use disorder; Opioid agonist maintenance; Postoperative pain management
• ISSN: 0889-8545; 1558-0474
• DOI: 10.1016/j.ogc.2020.04.005

Pregnant and postpartum women with opiate use disorder present a challenge in perinatal care. It is important for health care teams to provide sensitive and compassionate evidence-based care for these women, who often are stigmatized during the prenatal, delivery, and postpartum periods. Women with opiate use disorder are at risk for inadequate prenatal and postpartum care and for complications. Infants are at risk for neonatal abstinence syndrome and are expected to require neonatal intensive care. Pain management during labor and for cesarean delivery requires consultation and collaboration with providers who have expertise in management of addiction. Postpartum follow-up is essential.