Smoking in Pregnancy

1
Smoking in Pregnancy

• Dr Shonag Mackenzie
• Consultant Obstetrician and Gynaecologist

2
Prepregnancy and Early Pregnancy

• Fertility
• Miscarriages
• Ectopic Pregnancy

3
Antenatal Problems

• Fetal anomalies
• Intrauterine Growth Restriction
• Abruption/placenta praevia
• Prematurity
• Stillbirth
• Intrapartum Problems

4
Identify the smokers

• Need to know
• 14 in North East
• Teenagers
• Record/Assess
• Document change in smoking behaviour

5
Roles and Responsibilities

• Health professional and client
• Giving information
• Accurate
• Format/message that is appropriate
• Difficult messages
• Dont overwhelm

6
Resources

• High risk pregnancy
• Not consultant booked
• No growth scans
• NO INCREASED MONITORING UNTIL A PROBLEM DEVELOPS

7
Giving information

• 4000 chemicals
• Carbon monoxide
• Car fumes

8
Giving information

• Common myth Small baby Easier to deliver
• Small baby unhealthy
• Higher risk intervention
• More complicated labour/delivery

9
Giving information

• Scan findings
• Biophysical profile
• Placenta

10
Nicotine replacement

• Significantly helped
• Positive message
• Recognises addiction

11
Difficult Messages

• Miscarriage
• Stillbirth
• Not being honest and giving accurate
  information/advice is a dereliction of duty
• It is not about your comfort/feelings

12
Conclusion

• Smoking kills babies
• NRT decreases risks
• Reality is poor resources for this high risk
  group
• True figures needed
• Every health professional has a duty to discuss
  smoking behaviour

13
THANK YOU