Abstract：
BACKGROUND: Gamma hydroxybutyrate (GHB) is used illicitly for its sedative hypnotic effects, and those who take it regularly are at risk of developing a substance use disorder. Withdrawal from GHB can include severe symptoms that may require medical management. For GHB use and withdrawal during pregnancy, there are no evidence- or practice-based guidelines to follow, and there is only minimal research literature.
METHODS: We present the case of a 32-year-old woman, G1P0 at 29 weeks and 6 days of gestation, admitted to the perinatal unit at a tertiary hospital for GHB withdrawal management and stabilization. GHB withdrawal was managed with a combination of baclofen and diazepam. We report the dosing and tapering of these medications throughout her 14-day admission. Withdrawal symptoms were well managed with this medication protocol, and she did not experience any features of complicated withdrawal. The patient later presented to hospital in preterm labor and precipitously delivered a healthy, preterm infant male at 34 weeks and 5 days of gestation. At 7 months postpartum, the patient continued to engage with perinatal addiction service, reported no use of GHB since her admission, and was parenting her healthy son.
CONCLUSIONS: There is a paucity of guidelines for managing GHB withdrawal in pregnancy. This case demonstrates good clinical outcomes administering a short-term combination of diazepam and baclofen during the third trimester of pregnancy. This case helps to fill a gap in the literature and may inform future research or clinical decision-making in similar situations.
METHODS: We present the case of a 32-year-old woman, G1P0 at 29 weeks and 6 days of gestation, admitted to the perinatal unit at a tertiary hospital for GHB withdrawal management and stabilization. GHB withdrawal was managed with a combination of baclofen and diazepam. We report the dosing and tapering of these medications throughout her 14-day admission. Withdrawal symptoms were well managed with this medication protocol, and she did not experience any features of complicated withdrawal. The patient later presented to hospital in preterm labor and precipitously delivered a healthy, preterm infant male at 34 weeks and 5 days of gestation. At 7 months postpartum, the patient continued to engage with perinatal addiction service, reported no use of GHB since her admission, and was parenting her healthy son.
CONCLUSIONS: There is a paucity of guidelines for managing GHB withdrawal in pregnancy. This case demonstrates good clinical outcomes administering a short-term combination of diazepam and baclofen during the third trimester of pregnancy. This case helps to fill a gap in the literature and may inform future research or clinical decision-making in similar situations.
摘要：
背景：羟基丁酸γ（GHB）被非法用于镇静催眠作用，那些经常服用它的人有患上物质使用障碍的风险。退出GHB可能包括可能需要医疗管理的严重症状。对于怀孕期间使用和戒断GHB，没有基于证据或实践的指导方针可以遵循，只有很少的研究文献。
方法：我们介绍一个32岁女性的案例，G1P0在妊娠29周和6天，在三级医院的围产期病房接受GHB戒断管理和稳定。使用巴氯芬和地西泮的组合管理GHB戒断。我们报告了她14天入院期间这些药物的剂量和逐渐减少。戒断症状通过这种药物方案得到了很好的控制，她没有任何复杂的戒断特征。该患者后来在早产中被送往医院，并迅速分娩了健康的，妊娠34周和5天的早产儿男性。产后7个月，患者继续参与围产期成瘾服务，报告说她入院后没有使用GHB，养育她健康的儿子.
结论：目前缺乏管理妊娠期GHB戒断的指南。该病例显示了在妊娠晚期给予地西泮和巴氯芬短期组合的良好临床结果。这种情况有助于填补文献中的空白，并可能在类似情况下为未来的研究或临床决策提供信息。
方法：我们介绍一个32岁女性的案例，G1P0在妊娠29周和6天，在三级医院的围产期病房接受GHB戒断管理和稳定。使用巴氯芬和地西泮的组合管理GHB戒断。我们报告了她14天入院期间这些药物的剂量和逐渐减少。戒断症状通过这种药物方案得到了很好的控制，她没有任何复杂的戒断特征。该患者后来在早产中被送往医院，并迅速分娩了健康的，妊娠34周和5天的早产儿男性。产后7个月，患者继续参与围产期成瘾服务，报告说她入院后没有使用GHB，养育她健康的儿子.
结论：目前缺乏管理妊娠期GHB戒断的指南。该病例显示了在妊娠晚期给予地西泮和巴氯芬短期组合的良好临床结果。这种情况有助于填补文献中的空白，并可能在类似情况下为未来的研究或临床决策提供信息。
