Antepartum Monitoring of the Fetus Chronically Exposed to Opioids: What To Expect and Why Do We Intervene?
ACOG ePoster. Brar B. Apr 27, 2018; 211593; 22C
Bobby Brar
Bobby Brar
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Introduction: Chronic opioid dependence for maternal pain management, methadone maintenance, or suboxone therapy is an increasing phenomenon in obstetrics. Opioids may depress fetal neurobehavioral status and may change reactivity or variability of fetal heart rate patterns. Our primary objective was to determine which fetal assessment modality best identifies the vulnerable opioid exposed fetus.

Methods: A retrospective review from January 2016 through April 2017 at two MFM antenatal centers identified singleton, non-syndromic fetuses with daily opioid exposure. Non-stress tests (NST), biophysical profiles (BPP), amniotic fluid index (AFI), umbilical artery Doppler's (UAD), and serial biometry were reanalyzed. Test characteristics and frequency of interventions for abnormal monitoring were quantified.

Results: Criteria was met in 27 patients (77.8% methadone (n=21), 14.8% prescription opioid (n=4) and 7.4% suboxone (n=2)). There were 112 growth scans, 102 BPP, 112 NST, and 81 UAD measurements. Time to NST first acceleration was
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