Pregnancy & morphine use

Specialties Ob/Gyn

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Hi all! I do home visits to pregnant moms. One patient is on BR for severe back pain (nerve compression exacerbated by pregnancy). I have an appt to see her Monday. I spoke with her a few days ago for the first time, and she told me she is taking morphine for the pain. I was shocked, asked her to read the label to me, and it is indeed morphine that she is taking.

I'm at home and don't remember the EDC, but I believe it is within 2 months.

From the info I've seen, morphine doens't have teratogenic effects on the baby, but can cause newborn withdrawal, correct? Anyone have experience with this? What can/should I tell this mom?

As far as I am aware Jayla you are correct in your assumptions if this woman has been taking regular doses of morphine the baby may well go through a period of withdrawal after birth. The same precautions and plan of action should be in place as if she were using heroin.

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Excellent info on opiod effects on newborns.

Yes, the baby will have to withdraw. It's not fun for caregivers to watch and deal with. Expect some behaviors such as excessive sucking, crying, inconsolability. Also take seizure precautions---yes in some cases this can happen. Watch for it.

Anyhow here is the article info: It's from a Canadian agency--- AADAC (the Alberta Alcohol and Drug Abuse Commission). Hope it helps.

Effects on the Newborn

To date, none of the opioid drugs, including heroin and methadone, have been shown to produce physical birth defects in babies, although some research has found higher than usual rates of visual defects (e.g., strabismus). The most consistently reported effect on newborns is intrauterine growth retardation (IUGR), resulting in smaller-than-normal head size and low birth weight. It appears that infants born to methadone-maintained women who receive good prenatal care have relatively higher birth weights than do babies born to women who abuse heroin during pregnancy and have no prenatal care.

When opioids are taken during pregnancy, the fetus becomes physically dependent and usually undergoes opioid withdrawal after birth. It is estimated that 60 to 70 per cent of infants born to mothers using heroin or methadone experience neonatal abstinence syndrome. Neonatal abstinence syndrome (NAS) primarily affects an infant's central nervous system. Gastrointestinal tract problems are also common. The symptoms of withdrawal in newborn babies can include excessive sucking, muscle spasms, irritability, sweating, fever, seizures, breathing problems, high-pitched crying, disturbed sleep and feeding, stuffy nose, sneezing, hiccups, vomiting, and diarrhea. Symptoms usually develop 48 to 72 hours after birth, but may take up to

will withdraw, yes.

http://corp.aadac.com/other_drugs/the_basics_about_other_drugs/opioids_and_pregnancy_beyond_abcs.asp

for full article.

Hi all! I do home visits to pregnant moms. One patient is on BR for severe back pain (nerve compression exacerbated by pregnancy). I have an appt to see her Monday. I spoke with her a few days ago for the first time, and she told me she is taking morphine for the pain. I was shocked, asked her to read the label to me, and it is indeed morphine that she is taking.

I'm at home and don't remember the EDC, but I believe it is within 2 months.

From the info I've seen, morphine doens't have teratogenic effects on the baby, but can cause newborn withdrawal, correct? Anyone have experience with this? What can/should I tell this mom?

That she should go and see her OB ASAP...with the notice...

Ginny DOula RN SNM

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