Ethanol and tobacco abuse in pregnancy: Anaesthetic considerations

Abstract

The illicit drug abuse in pregnancy has received significant attention over the past two decades. However, far too little attention has been given to the consequences of the use of social drugs such as ethanol and tobacco, which are by far the most commonly abused substances during pregnancy. While the deleterious effects of cocaine or amphetamines on the mother and the fetus are more pronounced and easier to detect, the addiction to ethanol and tobacco is usually subtle and more difficult to diagnose. As a result recreational use of alcohol and tobacco may continue undetected in pregnancy, significantly effecting pregnancy outcome and obstetric and anaesthetic management of these patients. This article reviews the consequences of ethanol and tobacco use in pregnancy and offers recommendation for anaesthetic management of these potentially complicated pregnancies.