Amphetamines and Other Stimulant Use
Stimulant abuse, particularly methamphetamine, increased dramatically among women of childbearing age between 1994 and 2006; however, the rate of abuse has plateaued since and use during pregnancy is difficult to estimate. Maternal physiologic effects are similar to that of cocaine, with sympathetic system activation during periods of acute intoxication and significant psychosis with long-term use. Poorer obstetric and neonatal outcomes to include preterm delivery, placental abruption, and small for gestational age deliveries occur; however, long-term child outcomes appear similar to that of non-stimulant-abusing women. Intra- and postpartum obstetric management are similar to that of the cocaine-abusing mother. Neuraxial blockade may be complicated by more frequent and more difficult to treat hypotension due to catecholamine depletion in the chronic non-intoxicated abuser.
KeywordsAddiction Obstetric anesthesia Stimulants MDMA Amphetamine Ecstasy
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