Edelson P Kaitlyn, Bernstein Sarah N
Department of Obstetrics and Gynecology Founders 4, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
Curr Treat Options Cardiovasc Med. 2019 Nov 22;21(11):73. doi: 10.1007/s11936-019-0777-5.
Substance use disorder in pregnancy and subsequent cardiovascular complications are on the rise in the USA. The care of pregnant women with substance use disorder is complex, and requires a thorough understanding of mechanisms of action, pathophysiology, and cardiovascular response during pregnancy. The goal of this review is to provide information about the most common drugs of abuse in pregnancy and to recommend management guidelines.
Pregnant women with substance use disorder are at increased risk of significant cardiovascular complications, both as a direct effect of acute intoxication as well as the secondary risk from infection and cardiotoxicity associated with chronic use. This risk must be considered in the antepartum management, delivery, and postpartum periods. Understanding the increased cardiovascular risk of pregnant women with substance use disorder, as well as specific drug interactions, anesthesia considerations, best practices, and management considerations, is important for all clinicians caring for this population.
在美国,孕期物质使用障碍及随后的心血管并发症呈上升趋势。患有物质使用障碍的孕妇护理工作复杂,需要深入了解孕期药物作用机制、病理生理学及心血管反应。本综述的目的是提供有关孕期最常见滥用药物的信息并推荐管理指南。
患有物质使用障碍的孕妇出现严重心血管并发症的风险增加,这既是急性中毒的直接影响,也是慢性使用相关感染和心脏毒性的继发风险。在产前管理、分娩及产后阶段都必须考虑这一风险。了解患有物质使用障碍孕妇增加的心血管风险以及特定药物相互作用、麻醉注意事项、最佳实践和管理注意事项,对所有照料这一人群的临床医生而言都很重要。