Maternal Substance Abuse in Pregnancy

Substance abuse is common in women of childbearing age. Cocaine abuse is the most harmful, and can lead to IUGR, premature labor, uterine-placental insufficiency, or abruption. The mother may be tachycardic, hypertensive, or euphoric, and is at risk for MI, arrhythmias (potentially lethal), pulmonary edema, seizures, SAH. In treating parturients on cocaine, avoid pure beta-blockers as they can precipitate unopposed alpha stimulation.