A Synthetic Cannabinoid Use in Pregnancy: A Brief Educational Intervention for Obstetric Providers and Patients [19I

Abstract

INTRODUCTION: Synthetic Cannabinoid (SC) use is on the rise with the Substance Abuse and Mental Health Services Administration reporting a doubling of visits to Emergency Departments between 2010 and 2011 and has continued to rise resulting in increased federal attention and regulation. An acute intoxication syndrome is characterized by sympathomimetic effects, psychosis, hallucinations, delirium, acute kidney injury and even death. This drug is not detected by routine urine drug testing and no rapid testing currently exists. There is no antidote and treatment is largely supportive. The Obstetric Provider should be familiar with the mechanism of action, presentation, workup and treatment of this drug and its particular obstetric sequelae. METHODS: A literature review was performed on the SC and Pregnancy on the PubMed database and found 0 studies on SC use in Pregnancy. One study was found regarding SC and potential reproductive outcomes. An extensive literature search was then performed on SC use in non-pregnant patients. This information was used to create two brief evidence-based educational pamphlet one for providers and one for patients. RESULTS: The synthetic cannabinoids should be avoided in pregnancy. There is a baseline danger of the acute intoxication syndrome with these substances that can put the maternal fetal unit in danger. Pregnancy specific concerns include the effects of cannabinoids on neuronal migration in early pregnancy and the impact of altered autonomic regulation on the fetoplacental unit. CONCLUSION: An evidence based intervention for Obstetric Providers and Patients may help provide information on this growing substance epidemic for both obstetric providers and patients.