Multifocal Multi-organ Ischaemia and Infarction in a Preterm Baby Due to Maternal Intravenous Cocaine Use: A Case Report

Ben C Reynolds; Dawn MK Penman; Allan G Howatson; Lesley A Jackson; Charles H Skeoch

Disclosures

J Med Case Reports. 2009;3:9324 

In This Article

Abstract and Introduction

Abstract

Introduction: Although the adverse effects of cocaine use in pregnancy are well recognised, we believe this case highlights the importance of considering the route of administration, and suggests the possibility of multifocal damage relating to intravenous use.
Case presentation: A Caucasian female baby of 29-weeks' gestation was spontaneously delivered and subsequently developed multi-organ failure considered unrelated to simple prematurity. Intensive care was re-orientated following the development of massive intraventricular haemorrhage.
Conclusion: This case illustrates the need for regular cranial ultrasound in babies of pregnancies at risk due to intravenous cocaine use and also the necessity of counselling women who misuse cocaine in the antenatal period. As such, this article will be of most interest to paediatric and obstetric staff.

Introduction

Cocaine use in pregnancy has been associated with adverse fetal outcomes including congenital malformations. We report a female baby of 29 weeks' gestation whose mother had extensive polydrug misuse throughout her pregnancy, including the use of intravenous cocaine. Following spontaneous delivery, the baby died after three days of intensive support. A post-mortem examination revealed widespread ischaemic change throughout multiple organs. We hypothesise that the unusual extent of this damage is related to the route of administration and dosage of cocaine during the pregnancy.

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