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Heroin Addiction and Related Clinical Problems: 2014, 16, 2 (pages: 47 - 52)

Case report: Pregnancy and birth under Heroin-assisted Treatment (HAT)

Groh A., Urlichs F., Hillemacher T., Bleich S., and Heberlein A.

Summary: The treatment of opiate-dependent women during pregnancy is a common problem. Maintenance treatment with methadone is the best-established treatment, although a few case reports demonstrate the possible advantages of buprenorphine and slow release morphine in limiting the intensity of the postnatal, neonatal withdrawal syndrome. Here we report on the course of pregnancy and the postnatal withdrawal symptom of the son of a 25-year-old, first childbearing woman in her 38th week of pregnancy under diamorphine-assisted treatment (HAT=heroin-assisted treatment). Until the beginning of her pregnancy Mrs. X was maintained on diamorphine for about a year; apart from diamorphine, the only medicinal treatment was low dosages of quetiapine ad libitum, which were prescribed to treat nightmares and sleep-onset disorder. The pregnancy under diamorphine maintenance caused no major problems, and childbirth by Caesarean section took place in the 38+2 week of her pregnancy, although Mrs. X's son's neonatal withdrawal syndrome turned out to be more severe, and to show an earlier onset compared with methadone or buprenorphine treatments.