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Published online by Cambridge University Press: 01 September 2022
The use of psychoactive substances in pregnancy has a similar profile to the general population, in which ethyl alcohol and tobacco are the most widely used drugs, followed, to a much lesser extent, by marijuana and cocaine. Cocaine is a powerful stimulant of the Central Nervous System. Like other smokable cocaines, PBC is highly fat soluble and rapidly crosses the blood-brain barrier, causing maternal-fetal harm when consumed during pregnancy. Being its pathophysiological mechanism the vasoconstriction of uterine and fetal vessels. Obstetric complications related to this toxic mechanism of action include: increased risk of spontaneous abortion, premature detachment of the normal inserted placenta, and intrauterine growth restriction.
We present how was the management of a 26-year-old woman, polytoxic, unemployed, living in a “squatting house”, referred from the Gynecology and Obstetrics service to the Addictive Behavior Unit, due to fetal alterations seen in ultrasound follow-ups. Presenting the fetus: delayed intrauterine growth, and bilateral ventriculomegaly with dilation of the left ventricle.
We report this case to social services and we started doing a weekly poison check. Presenting positive controls for both: cannabis and cocaine.
Due to the physical, psychological and environmental situation of the patient, the withdrawal of custody of her child is being considered.
These types of cases must be treated in a multidisciplinary way, with awareness of the disease and the consequences of continuing to consume must be addressed.
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