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Old 06-27-2012
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Default A 23-year-old woman is delivered of a stillborn...

A 23-year-old woman is delivered of a stillborn fetus at 36 weeks' gestation. The woman experienced sudden onset of lower abdominal pain several hours before delivery. An abdominal ultrasound scan showed a large retroplacental hemorrhage. Delivery was accompanied by a 1200-ml blood loss. Maternal use of which of the following agents is most likely to be associated with this findings?

a) acetaminophen
b) amphetamine
c) cannabinoids
d) cocaine
e) ethanol
f) heroin
g) lysergic acid

Please try to briefly explain your choice
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Old 06-27-2012
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d) cocaine, ---> placental abruption
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Old 06-28-2012
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Default correct answer

Correct answer is D) cocaine

Cocaine has powerful vasoactive effects, including vasoconstriction. The effects on the placenta can include decreased blood flow with fetal hypoxia and spontaneous abortion, placenta abruption, end fetal hemorrhages. Chronic maternal cocaine use results in neurologic impairment of infants.

Acetaminophen od -> hepatic necrosis and encephalopathy
Amphetaminen od-> cardiovascular effects, including arrhythmias
Cannabinoids -> mild tranquilizeres, no major tissue effect
Ethanol -> fetal alcohol syndrome, which is not fetal but results in subtle anomalies and impaired development
Heroin-> fetal cardiorespiratory depression but not hemorrhage
Lysergic acid (LSD) -> does not cause hemorrhage
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