Introduction
Fetal Alcohol Spectrum Disorders (FASD): No safe amount of alcohol at any point in pregnancy Teratogenic throughout gestation; 1st trimester = highest risk for structural defect...
Fetal Alcohol Spectrum Disorders (FASD): - No safe amount of alcohol at any point in pregnancy - Teratogenic throughout gestation; 1st trimester = highest risk for structural defects - Leading preventable cause of intellectual disability in the US - Fetal alcohol syndrome (FAS): diagnostic criteria: * Growth restriction (prenatal/postnatal LBW) * Facial features: smooth philtrum, thin vermilion border (upper lip), small palpebral fissures * CNS abnormalities: microcephaly, intellectual disability, behavioral disorders, learning disabilities - FASD spectrum: partial FAS, neurodevelopmental disorder without facial features Opioids: - Use in pregnancy rising dramatically (opioid crisis) - Risks: fetal growth restriction, preterm birth, placental abruption - Neonatal Opioid Withdrawal Syndrome (NOWS/NAS): * Onset: 24–72 hours after birth (heroin), 2–4 days (methadone) * Symptoms: tremors, high-pitched cry, poor feeding, sneezing, yawning, rhinorrhea, seizures * Assessment: Finnegan Neonatal Abstinence Scoring System (NAS score) * Treatment: non-pharmacological first (swaddling, low stimulation, skin-to-skin, feeding on demand); pharmacological (morphine, methadone) if NAS score criteria met - Medication-assisted treatment (MAT) in pregnancy: * Methadone or buprenorphine: standard of care for opioid use disorder in pregnancy * Reduces illicit drug use,...
