Kain Z N, Rimar S, Barash P G
Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06510.
Anesth Analg. 1993 Oct;77(4):835-45. doi: 10.1213/00000539-199310000-00030.
The growing use of cocaine among pregnant women and women of childbearing age has become an issue of great concern to physicians. Cocaine abuse among parturients is associated with multi-target organ involvement, including the cardiovascular, respiratory, neurologic, and hematologic systems. Cocaine use during pregnancy is also an independent contributor to the risk of placental abruption, preterm labor, precipitate delivery, stillbirth, and others. Although a history of premature rupture of membranes, smoking, alcohol use, syphilis serology, and use of other illicit drugs suggests cocaine abuse, the single most important predictor is the absence of prenatal care. The intraoperative anesthetic management should take into consideration the different effects of cocaine on the mother, the fetus, and the neonate.
孕妇和育龄妇女中可卡因使用的增加已成为医生极为关注的问题。产妇滥用可卡因与多靶器官受累有关，包括心血管、呼吸、神经和血液系统。孕期使用可卡因也是胎盘早剥、早产、急产、死产及其他情况风险的独立促成因素。虽然胎膜早破史、吸烟、饮酒、梅毒血清学及其他非法药物使用提示可卡因滥用，但最重要的单一预测因素是未进行产前检查。术中麻醉管理应考虑可卡因对母亲、胎儿和新生儿的不同影响。
