[15] Maternal Substance

Cards (31)

  • Maternal Substance Abuse: use of harmful substances by pregnant woman that can put both the mother and the fetus at risk
  • Maternal Substance Abuse is one of the most significant risk factors associated for adverse birth outcomes
  • Common Substances
    • Licit
    • Illicit
    • Prescription Drug use or misuse
  • Licit Substances
    • Legal
    • Regulated or unregulated by the government
    • alcohol, cigarettes, caffeine
  • Illicit Substances
    • Illegal
    • Tightly controlled by the government
    • cocaine, heroin, methamphetamine (shabu)
  • Prescription Drug Use or Misuse
    • can be attained with the prescription of medical professional
    • opioids, morphine, tramadol, oxycodone
  • opioids: use for pain killer
  • Drug Misuse
    • using of drugs outside if its intended use
    • example: opioids not used for pain killers but rather for the effects of being high
  • Most common use substance
    • Nicotine, alcohol, marijuana (cannabis), opioids
  • Nicotine
    • highly addictive chemical compound found in tobacco plants
    • acts as depressant and stimulant
    • tobacco & cigarettes
  • Alcohol
    • chemical compound found in wine, beer, liquor
    • acts as depressant which affect CNS leading to changes in mood, behavior and cognitive function
  • Marijuana (Cannabis)
    • Psychoactive drug found in cannabis sativa plant
    • acts as stimulant and depressant
  • Opiates
    • class of drugs that are derived from opium poppy plant
    • can be synthesized to mimic the effects of natural opioids
    • commonly used for pain reliver properties
  • Timing of the teratogenic exposure
    • Preimplantation (first 2 weeks)
    • Embryonic (3rd - 8th weeks)
    • Fetal (8th week onwards)
  • Preimplantation (first 2 weeks)
    • between fertilization and implantation
    • not yet susceptible to teratogens
    • all or nothing period
  • Embryonic (3rd to 8th week)
    • eventful: formation of 3 germ layers & major structures
    • greatest effect & most vulnerable for abnormalities
    • CNS, Heart, Upper & Lower Limbs, Eyes, Teeth
  • Fetal (8th week onwards)
    • period for continued functional development and maturation
    • only some organs are vulnerable
  • Specific condition for maternal substance abuse
    • Fetal Alcohol Spectrum Disorders
    • Neonatal Opioid Withdrawal Syndrome
  • Fetal Alcohol Spectrum Disorder (FASD)
    • also known as Fetal Alcohol Syndrome (FAS)
    • broad range of emotional, cognitive, behavioral, and congenital abnormalities
    • entirely preventable with the total absence of alcohol
    • commonly seen in Leyte because of Tuba (palm wine)
  • Fetal Alcohol Spectrum Disorder (FASD) diagnosis is often complex due to multiple factors and negative exposures
  • Fetal Alcohol Spectrum Disorder (FASD) TRIAD Symptoms
    • Short palpebral fissure
    • Flat philtrum
    • Thin upper vermillion
  • Fetal Alcohol Spectrum Disorder (FASD) Other Symptoms
    • Microcephaly (Small Head)
    • CNS Impairment
    • Attention
    • Reaction Time
    • Executive Function
    • Memory
    • Language
    • Social Adaptive Functions
  • Fetal Alcohol Spectrum Disorder (FASD)
    • no pathognomonic specifics in terms of neurodevelopmental deficits
  • Neonatal Opioids Withdrawal Syndrome (NOWS)
    • Subset of Neonatal Abstinence Syndrome (NAS)
    • happens in Neonates
    • due to sudden withdrawal of intrauterine (in the uterus) drug exposure
    • baby in the tummy is exposed to opioids
  • Neonatal Opioids Withdrawal Syndrome (NOWS) Prevalence
    • notable increased globally
    • little information in PH
  • Neonatal Opioids Withdrawal Syndrome (NOWS) TRIAD Symptoms
    • Increased Muscle tone
    • Tremors when undisturbed
    • Exaggerated Moro reflex (Startle Reflex)
  • Neonatal Opioids Withdrawal Syndrome (NOWS) System Symptoms
    • CNS
    • Autonomic
    • Respiratory Disturbances
    • GI Disturbances
  • Neonatal Opioids Withdrawal Syndrome (NOWS) CNS Symptoms
    • Hyperirritability
    • High Pitch Crying
    • Jitteriness
    • Tremors
  • Neonatal Opioids Withdrawal Syndrome (NOWS) GI Symptoms
    • poor feeding
    • regurgitation
    • vomiting
    • diarrhea
  • Comprehensive Prenatal Care
    • Initial Evaluation
    • Emotional & Social Support
    • Regular Check-ups
    • Management on pregnancy complications
    • Patient Education
    • Newborn Assessment
  • Treatment on FASD and NOWS
    • Interdisciplinary Team
    • Early Intervention
    • Pharmacologic
    • Parent Training