Marijuana in pregnancy.
BACKGROUND
The prevalence of recreational drug abuse among young adults, including women, has increased markedly over the last 2 decades. Nearly 90 % of these women are of childbearing age. Marijuana remains the drug most commonly used for recreational purposes in pregnancy. However, there appears to be an absence of uniform guidelines for obstetric and anaesthetic management of pregnant patients with a history of marijuana abuse.


METHODS
A Medline search for articles highlighting drug abuse in pregnancy, with particular emphasis on marijuana abuse in pregnancy, the drug 's impact on the fetus and implications for administration of obstetrical anaesthesia was performed.


RESULTS
Because the pharmacological actions of marijuana are complex and include a unique blend of effects, the clinical picture could be very unpredictable, the diagnosis often difficult, and management at times controversial.


CONCLUSIONS
In the absence of uniform anaesthetic guidelines for pregnant patients with a history of drug abuse, including abuse of marijuana, the decision regarding administration of peripartum analgesia or anaesthesia should be individualised and conducted on a case-by-case basis.
Kuczkowski
K M
KM
UCSD Medical Center, San Diego 92103-8770, USA. kkuczkowski@ucsd.edu
D000773:Anesthesia, Obstetrical; D002186:Cannabinoids / Q000494:pharmacology; D005260:Female; D005333:Fetus / Q000187:drug effects; D006801:Humans; D002189:Marijuana Abuse / Q000175:diagnosis / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000503:physiopathology; D011297:Prenatal Exposure Delayed Effects
D002186:Cannabinoids