Mental Health Book


Substance Abuse in Pregnancy

Aka: Substance Abuse in Pregnancy, Chemical Dependency in Pregnancy
  1. See Also
    1. Chemical Dependency
    2. Substance Abuse Evaluation
    3. Cocaine Abuse in Pregnancy
  2. Risk Factors: Child Abuse Associations
    1. Substantial increase in risk of maltreatment
    2. Risk of change in primary Caregiver before age 2 years
    3. Breast Feeding exposure to illicit substance
    4. Deliberate Poisoning with illicit substance
    5. Passive inhalation of illicit substance
    6. Accidental Ingestion of illicit substance
    7. Physical or Sexual abuse
    8. Household or neighborhood Violence
  3. Management: Preterm Recommendations for Obstetric Visits
    1. Every 2 weeks until 30 weeks
    2. Every week until delivery after 30 weeks
  4. Labs: Sexually Transmitted Disease screening
    1. First Prenatal Visit
    2. Gestational age 36 weeks
    3. Testing
      1. Syphilis Serology
      2. Condyloma
      3. Gonorrhea Culture
      4. Chlamydia screen
      5. Herpes Genitalis
      6. Hepatitis B Serology
      7. HIV Testing
  5. Imaging: Obstetric Ultrasound
    1. Baseline: late first or early second trimester
    2. Serial Ultrasound for Intrauterine Growth Retardation
  6. Monitoring
    1. Random Urine Drug Screening (obtain permit)
    2. Obstetric Ultrasound as above
    3. Nonstress Test
      1. Every two weeks from 30 to 35 weeks
      2. Weekly after 35 weeks
    4. Meconium Drug Screen from fetus after delivery
  7. Management
    1. Child Protective Services reporting is required

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