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Pregnancy and Naltrexone Pharmacotherapy

Jones, Cresta W., MD; Terplan, Mishka, MD, MPH

doi: 10.1097/AOG.0000000000002864
Opioids: Clinical Conundrums: PDF Only

A 25-year-old woman, gravida 3 para 2 at 12 weeks of gestation, with two prior cesarean deliveries, presents for prenatal care. She is in treatment for opioid use disorder on extended-release naltrexone injection, with a history of opioid overdose, relapse, and poor treatment adherence on methadone and buprenorphine. She asks, “Is it safe for my baby if I continue on this medication? How will you manage my postoperative pain?”

Naltrexone, an opioid antagonist used for the treatment of opioid use disorder, is not well- studied in pregnancy and may pose challenges for analgesia and anesthesia surrounding delivery.

Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, Minneapolis, Minnesota; and Virginia Commonwealth University, Richmond, Virginia.

Corresponding author: Cresta W. Jones, MD, Department of Obstetrics, Gynecology and Women’s Health, University of Minnesota Medical School, 606 24th Avenue, S, #401, Minneapolis, MN 55455; email: jonesc@umn.edu.

Financial Disclosure The authors did not report any potential conflicts of interest.

Each author has indicated that he or she has met the journal's requirements for authorship.

Received May 07, 2018

Received in revised form June 29, 2018

Accepted July 12, 2018

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.