Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 833 Chestnut Street, Philadelphia, PA, United States.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Thomas Jefferson University Hospital, 833 Chestnut Street, Philadelphia, PA, United States.
Semin Perinatol. 2019 Apr;43(3):168-172. doi: 10.1053/j.semperi.2019.01.006. Epub 2019 Jan 14.
Pregnancy presents a window of opportunity for effecting positive change in the lives of women with opioid use disorder (OUD). Care should be empathetic and nonjudgmental with a focus on counseling for initiation and maintenance of beneficial health behaviors as well as development of a strong patient-provider relationship. These include adherence to treatment of OUD through pharmacotherapy and behavioral counseling, smoking cessation, healthy nutrition, treatment of coexisting medical and psychosocial conditions, as well as preparation for the postpartum period through breastfeeding education and antenatal discussion of contraception. Women will also benefit from anticipatory guidance with regard to neonatal abstinence syndrome (see Chapter 7). This may include a consultation with pediatric or neonatal providers who will be caring for their infants. In the absence of other obstetric indications, minimal additional fetal assessment outside that of standard prenatal care is recommended for OUD.
妊娠为患有阿片类药物使用障碍（OUD）的女性的生活带来了积极改变的机会。护理应该富有同理心且不做评判，重点在于咨询，以启动和维持有益的健康行为，并建立牢固的医患关系。这些措施包括通过药物治疗和行为咨询来坚持治疗 OUD、戒烟、健康饮食、治疗并存的医疗和心理社会状况，以及通过母乳喂养教育和产前避孕讨论为产后时期做准备。对于新生儿戒断综合征（见第 7 章），女性也将受益于预期指导。这可能包括咨询儿科或新生儿提供者，他们将照顾她们的婴儿。在没有其他产科指征的情况下，建议 OUD 患者除了标准产前护理之外，只需进行最低限度的额外胎儿评估。
