Does the hospital in Brisbane have a specific drugs and pregnancy team?  If
so, this will be the way to go.

We do at most of the major hospitals in Vic, which, unfortunately will be of
no use.

Sally
----- Original Message -----
From: "Neretlis, Bethany" <[EMAIL PROTECTED]>
To: <[EMAIL PROTECTED]>
Sent: Saturday, August 16, 2003 1:07 PM
Subject: RE: [ozmidwifery] Fw:info please


dear tina
1) the effects of the drugs are varied. there is more risk of malformation
with heroin use than speed, however both will cause the babe to withdraw
after birth. it will be better for the babe if she breastfeeds as the babe
will get small doses through the breastmilk, and soften the withdrawal. i
have worked witha lot of term mums and babes during the postnatal period.
other than the withdrawal period, which can be very severe, i am not aware
of the longer term effects on the babe. there is a much greater risk of m/c
due to FDIU or malformation.
2) there is no effect from the herpes unless she has a current outbreak at
term and delivers vaginally. then the babe is greatly effected. if she has
an outbreak then she needs to have a c/s. it is possible to have
medicationto reduce the risk of an outbreak as she nears term is she wants,
and has seen her antenatal dr.
3)i am not sure of the risks of hep c transferral accross the placenta.
postnatally, there are proceedures to reduce the risks.
4)she needs to go to a tertiary hospital for her care as they will have the
best antenatal and postnatal care for her, and programms in place to deal
with her type of high risk pregnancy.
5)it is very unlikely that any treatment from 2 years ago will have any
effect now unless she is still using the medication.
6)there are more problems for the babe after birth from a disfuctional
family. however there isn't much to be done other than keep a close eye on
the babe and the mum it ensure there are no violence or neglect issues,
which are prevelent in this type of situation.

good luck in this very heart wrenching situation.

love  Bethany

-----Original Message-----
From: M & T Holroyd [mailto:[EMAIL PROTECTED]
Sent: Friday, 15 August 2003 17:16
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] Fw:info please



----- Original Message -----
From: M & T Holroyd
To: [EMAIL PROTECTED]
Sent: Wednesday, August 13, 2003 6:06 PM
Subject: Fw: Fw:info please


Hi, trying again.  Tina H.

----- Original Message -----
From: M & T Holroyd
To: [EMAIL PROTECTED]
Sent: Sunday, August 10, 2003 2:45 PM
Subject: Fw:info please


Hi, I tried this last week but had h**p in the wrong place.  Tina H.

----- Original Message -----
From: M & T Holroyd
To: [EMAIL PROTECTED]
Sent: Tuesday, August 05, 2003 9:56 PM
Subject: info please


Hi,  I have an urgent question from a friend of mine (J).  Her sister who is
21yo. has just found out she is about 1.5 to 2 months pregnant (she found
out 1 week ago).  J is concerned because her sister had a Hx of IV drug use
since approx 17yo, she also has Hep C (diagnosed 3 years ago).  To add to
this she smokes (has cut back a little since discovering her pregnancy) &
uses pot as well (was regular but my friend is unsure if still regular).  J
just found out today that her sister is still using speed (more so than
heroin) & heroin.  Her sister is very happy about her pregnancy, as is her
partner.  Sister suffers severe depression (also family Hx of
schitzophrenia), has regular severe ups & downs, and at the moment is
extremely tired & morning sick.  Her partner also has anger management
issues, is posessive & also uses drugs.  To top this off, she is also
suffering a current outbreak of genital herpes & used ? roaccutane (unsure
of spelling, but used for acne) last 2 years ago.  J was initally happy
(trying to be positive) for her sister (though worried) but since finding
out about the speed & heroin has become very concerned about affects on
pregnancy & baby.  J's parents are distraught & want her sister to have a
ternmination.  J is well educated & has given her sister a list of very
important things to do straight away but says that she is unreliable & when
did go to GP today, did not mention her drug use.

This all sounds so strange to me because I have never cared for someone in
this position, so had no answers for J.  So J's questions are:

1.  How might the different drugs affect this baby / pregnancy?
2.  What effects might the herpes have on this pregnancy?
3.  What effects will the Hep C. have on this baby (& transmission risks)?
4.  Who would be the best care providers for this woman.... what specialists
& resources should she access (& does the new ?Phoenix
     project at the RWH in Brisbane cover someone in this type of high risk
group)?
5.  Will the acne treatment 2 years ago still have any effects?
6.  Any comments on something she has not thought of.

J & I both would appreciate your input (please, please, please).

Thankyou all,

Tina H.  Brisbane. (Hope not to many mistakes, feeding babe whilst typing)
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