Drug use disorder and its management in women with a history of caesarean section: A systematic review of narrative review articles

Abstract

Introduction: Women with drug use disorder probably need larger amounts of drugs for analgesia during and after childbirth; however, due to the limited number of studies in this field, the present study was conducted with aim to evaluate drug use disorder and how to manage it in women with history of caesarean section. Methods: In this systematic review study which was conducted during 2000 until the first six months of 2022, in order to find related articles (published in both Persian and English), databases of PubMed, EMBASE, Cochrane Library, Web Of Science, Scopus, Mag-Iran and SID were searched using the keywords of pain, pain intensity, acute pain, chronic opioid pain, cesarean section, cesarean delivery, drug abuse disorder, pain management, prevention and analgesia. Results: Women with a history of caesarean who had drug use disorders faced unique challenges in accessing appropriate treatment and support. The results focused on the importance of integrated care models that addressed both the physical and psychological aspects of drug use disorder management. Additionally, specialized interventions tailored to the needs of this population, such as trauma-informed care and perinatal substance use programs, were found to be effective in improving outcomes. Conclusion: Optimal control of post-cesarean pain in women with drug abuse disorder includes a multifaceted strategy using intrathecal or epidural drugs, acetaminophen and non-steroidal anti-inflammatory agents as the first line.

Keywords

• cesarean section
• drug use disorder
• management
• pain