Marijuana in Pregnancy

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.

Abstract

Introduction: 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. Materials and 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. Conclusion: 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.