Cocaine in Pregnancy
NURS 341
What is cocaine?
● Cocaine- an addictive drug with negative effects on
the heart, brain, and emotions
● Cocaine blocks neurotransmitters in the brain
(norepinephrine, serotonin, and dopamine) →
o chemical buildup between nerve causes euphoria
● Euphoric feeling:
o increasing sense of energy and alertness
o extremely elevated mood
o a feeling of supremacy
Cocaine and pregnancy
● In 2005, approximately 4% of women using
illicit drugs including cocaine
● In mothers’ that use cocaine during
pregnancy, newborns have low birth
weight, intrauterine growth restriction and
decreased head circumference
Treatment/Interventions in
Antepartum
1) Referral to drug treatment and social
services.
2) Educate!
3) Examine Attitudes.
4) Communication.
Treatment/Interventions in
Intrapartum
1) Prevent Injury: Admitting, set limits, and
seizure precautions.
2) Pain Control: pharmacological and non
pharmacological.
Nurses Role
● Individual
o
early pregnancy interventions, consistent
individualized care, education, and delivery
management
● Physically
o
creating a non-bias environment, develop a plan of
care
● Mentally
o
non-judgmental assessment, continued support
Nursing
Diagnosis
1. Deficient knowledge r/t cognitive
limitations as evidenced by
inappropriate behaviors
2. Risk for disturbed maternal/fetal
dyad r/t substance abuse
3. Ineffective role performance r/t
substance abuse as evidenced by
inadequate self management
Outcomes for Mom
Preferably get them to stop drug use
● Education
● Social Services
● Pharmacologic Treatment
Higher risk of complications
● Delay of prenatal care
● Inadequate pain control during labor
● Decreasing drug use decreases risks!
Extended drug use or withdrawal
Outcomes for Baby
Neonatal Abstinence Syndrome (NAS)
● Affects several body systems
● Symptoms
o Can be seen as early as 24 hours or as late as 72 hours after
birth
● Affects 3.4 newborns in 1,000 births
● Strategies for comforting a newborn with NAS
Numerous studies have shown
1. High rates of preterm birth
2. low birth weight and small for gestational age
Continued
Decreased Language Development
Poor Neuromotor Functions
Possible Cognitive Impairment?
References
●
GEARY Jr, F. H., & Turnquest Wells, M. A. (2013). Management of the Patient in Labor Who Has Abused Substances.
Clinical Obstetrics & Gynecology, 56(1), 166-172.
●
Gouin K, Murphy K, Shah PS, et al. Effects of cocaine use during pregnancy on low birthweight and preterm
birth: systematic review and metaanalyses. Am J Obstet Gynecol 2011;204:340.e1-12.
●
Keegan, J., Parva, M., Finnegan, M., Gerson, A., & Belden, M. (2010). Addiction in Pregnancy. Journal of
Addictive Diseases,29(2), 175-191. doi:10.1080/10550881003684723
●
Ladwig, G., & Ackley, B. (2011). Mosby's guide to nursing diagnosis (4th ed.). Maryland Heights, Mo.: Mosby/Elsevier.
●
Lunsford BK. (1995, May). Pregnancy and cocaine: a charge to nurses. Kansas Nurse, 5, 8-9. Retrieved from
CINAHL.
Murray, S. S., & McKinney, E. S. (2014). Foundations of Maternal-Newborn and Women’s Health
Nursing (6th ed.). St Louis, MO: Elsevier Saunders.
Nora, J. G. (1990). Perinatal cocaine use: maternal, fetal, and neonatal effects. Neonatal Network, 9(2),
45-52. Retrieved from PubMed.
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