Prolonged morphine exposure in utero causes fetal and placental vasoconstriction: a case report.
Vasoconstriction was observed in the fetal middle cerebral and umbilical arteries by Doppler assessment at 27 weeks gestation in a patient requiring continuous morphine infusion for pain control. Fetal heart tracings were also concerning. Fetal status improved after a change to fentanyl infusion, a shorter acting opioid. Caution is recommended when long-term chronic narcotic infusion is used in pregnancy.
Collins
Laura R
LR
Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Hall
Richard W
RW
Dajani
Nafisa K
NK
Wendel
Paul J
PJ
Lowery
Curtis L
CL
Kay
Helen H
HH
D000328:Adult; D016362:Analgesia, Obstetrical; D005260:Female; D005333:Fetus / Q000098:blood supply*; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications; D017078:Laser-Doppler Flowmetry; D008431:Maternal-Fetal Exchange; D020768:Middle Cerebral Artery / Q000187:drug effects / Q000196:embryology; D009020:Morphine / Q000008:administration & dosage / Q000009:adverse effects*; D010920:Placenta / Q000098:blood supply*; D011247:Pregnancy; D011248:Pregnancy Complications; D014469:Umbilical Arteries / Q000187:drug effects / Q000196:embryology; D014661:Vasoconstriction / Q000187:drug effects*
D009020:Morphine