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Peripartum Management for Patients Receiving Medication for Opioid Use Disorder
Henry Paiste1, Brendan Lynch1, Grace Lim2
1Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, UPMC Magee Women's Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA.
Anesthesiology Clinics
|July 30, 2026
Summary
Opioid use disorder (OUD) significantly impacts peripartum care, posing risks to mothers and newborns. Effective management involves medication for OUD, anesthesia, and avoiding withdrawal triggers.
Area of Science:
- Obstetrics and Gynecology
- Addiction Medicine
- Pharmacology
Background:
- The opioid crisis has escalated, with significant implications for pregnant individuals.
- Opioid use disorder (OUD) presents unique challenges in the peripartum period.
- Neonatal Abstinence Syndrome (NAS) is a critical concern.
Purpose of the Study:
- To review the impact of opioid use disorder on peripartum care.
- To discuss maternal and neonatal risks associated with OUD.
- To outline current treatment strategies and anesthetic considerations.
Main Methods:
- Literature review of the opioid crisis and its obstetric implications.
- Pharmacological review of methadone and buprenorphine for OUD treatment.
- Analysis of anesthetic management in pregnant patients with OUD.
Main Results:
- OUD poses significant risks, including NAS, to mothers and neonates.
- Methadone and buprenorphine are key pharmacotherapies for OUD in pregnancy.
- Multimodal pain management and avoidance of withdrawal agents are crucial in obstetric anesthesia.
Conclusions:
- Comprehensive care is essential for pregnant individuals with OUD.
- OUD management requires a coordinated approach involving pharmacotherapy and anesthesia.
- Addressing regional disparities in opioid prescribing remains critical.
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