Obstetric Liaison in Drug Dependency

Abstract

This study describes the first two years of an obstetric liaison service between the Liverpool Drug Dependency Clinic and the two local maternity hospitals. The service comprised, medical officer, drug liaison midwife and a designated obstetrician at each of the hospitals. A total of 88 women were seen from whom there were 60 deliveries producing 61 babies, Only two women delivered without either service identifying their pregnancy. This compares to a previous estimated rate of 75% of drug users being undetected by the obstetric services. The amount of methadone a woman was taking did not predispose to any specific obstetric intervention. There was a higher rate of small for gestational age babies in this group but other factors may be more important than a mothers drug use. Higher levels of maternal methadone did not reduce foetal weight. There was a tendency to increase the risk of neonatal opiate withdrawal symptoms and premature labour with higher doses of methadone, although this requires further stu...