Clinical findings:
(1) signs of intoxication or withdrawal
(2) maternal complications
(3) complications in the placenta and/or fetus
Complications in the mother:
(1) stroke
(2) seizures
(3) myocardial ischemia or infarction
(4) cardiac dysrhythmias
(5) hypertension
(6) hyperthermia
(7) severe psychiatric disorder
Complications in the pregnancy:
(1) placental abruption
(2) placental infarction
(3) preterm labor with preterm delivery
(4) spontaneous abortion or stillbirth
(5) premature rupture of the membranes
(6) growth retardation (small for gestation)
(7) antenatal cerebral infarction in the fetus
(8) fetal distress with meconium staining of the amniotic fluid
A woman with one or more of these findings should be considered for drug testing to confirm (or exclude) and identify the drug of abuse.
Differential diagnosis:
(1) pre-eclampsia or eclampsia
