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A 21-year old woman presents for prenatal visit, her 1st even though she is well into her third trimester and her EDC is predicted to be within a month or so. He boyfriend, the father of the child, has not been supportive to date of the pregnancy and is also not on good terms with her own parents. At first, she denies alcohol or drug use but after a while, she opens up and talks about an ongoing opioid addictions. Most of the time, she takes Percocet bought on the street but due to cost, she has recently begun using heroin. It becomes clear that she will not be “clean” prior to her deliver and that her child will be born also addicted to narcotics. And as she has almost no external support, you know that after she delivers, she will be the primary caregiver of the infant and also hopefully working a detox program.

What is the accepted name of the condition with which the child will be born?

What are the peri-natal risks to the infant?

What are the post-natal risks to the infant?

What are the post-natal risks to the mother?

Is there an evidence on the long-term risk to the child?

  1. Are there any diagnostic studies that should be ordered on this patient? Why?
  2. List the primary diagnosis and at least two differential diagnoses for this patient. Explain your reasoning for each.
  3. Discuss your management plan for this patient, including patient education, referrals, and follow-ups.

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