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Counsel on Increased Risk With Pregnancy
- During pregnancy, ongoing pain management may be needed and is an important part of health management.
- Discuss risks and benefits of use of non-steroidal anti-inflammatory medications and opiates prior to and after conception.
- Abrupt discontinuation of narcotics can increase the risk of fetal death.
- Discuss risks of neonatal withdrawal syndrome for infants born to mothers using opiates during pregnancy. Management of neonatal withdrawal syndrome following delivery typically involves an ICU stay.
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Management
- Provide coordinated pain management by an interdisciplinary group of healthcare providers with experience in pain management. For women who want to conceive, this group should include a primary care provider (or specialist as applicable) and obstetrician/gynecologist.
- Use non-pharmacologic interventions when effective.
- Manage pain with opiates when needed. Consider transition to methadone maintenance.