Subcutaneous Extended-Release Buprenorphine Use in Pregnancy
Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...Now open: Certificate Course in Management of Covid-19 by Govt. Of Gujarat and PlexusMDKnow more...
Patient number one had an 8-year history of opioid use disorder. She was being managed with sublingual buprenorphine and then chose to transition to monthly Sublocade injections; the first of which was administered about 3 months prior to her last menstrual period. The first two injections were 300 mg doses followed by monthly 100 mg doses. The last injection occurred at a gestational age of 174/7 weeks. A total of 8 injections had been given. At 183/7 weeks’ gestation, the patient discovered she was pregnant (unplanned) and declined any further injections. Oral buprenorphine was offered for continued MOUD during her pregnancy, but she wanted to be opioid-free at delivery and again declined.

Patient number two had a 6-year history of opioid use disorder. She was also being managed with sublingual buprenorphine but was transitioned to monthly Sublocade injections. She received a total of 6 injections. The last injection occurred at the time of her last menstrual period. Oral buprenorphine was again offered for continued MOUD during her pregnancy, but she also declined. The prenatal care of both patients included an intensive behavioral health component.

Urine drug screens were negative for any other drugs except buprenorphine. For both patients, subcutaneous nodules were palpable across the upper abdomen area (the location of the injection sites). These disappeared at around 34 weeks’ gestation for patient number one and at 22 weeks’ gestation for patient number two. Both patients delivered vaginally at term without complications. Both newborns had normal Apgar scores and were discharged with their mothers. No birth anomalies were identified. Both mothers required only acetaminophen and ibuprofen during the postpartum period for pain control. Neither patient experienced any symptoms of opioid withdrawal. Both infants were monitored closely for 5 days postdelivery for signs of neonatal abstinence syndrome (NAS). NAS did not develop in either case.

Source: https://www.hindawi.com/journals/criog/2020/3127676/
Like
Comment
Share