Restricted accessCase reportFirst published online 2021-1
Thrombosis of the Renal Vein and Inferior Vena Cava Associated With Placental Fetal Vascular Malperfusion in a Neonate Exposed to Methadone Maintenance Therapy In Utero
Methadone, an opioid agonist, is the recommended treatment for pregnant women with opioid use disorder (OUD). Fetal/neonatal autopsy findings as well as placental changes in the setting of maternal OUD or methadone maintenance therapy (MMT) are not well-characterized. Here we present a case of a neonate who had exposure to MMT while in utero and died shortly after birth and was subsequently found to have multifocal calcified renal vein thrombosis, a recent inferior vena cava thrombus, and placental features of fetal vascular malperfusion at autopsy.
SerraAELemonLSMokhtariNB, et al.
Delayed villous maturation in term placentas exposed to opioid maintenance therapy: a retrospective cohort study.AM J Obstet Gynecol. 2017;
216;418.e1–5.
2.
AlinejadSGhaemiKAbdollahiMMehrpourO.Nephrotoxicity of methadone: a systematic review.Springerplus. 2016;
5(1):2087. doi:10.1186/s40064-016-3757-1
3.
SodhiNAnisHKAcuñaAJ, et al.
The effects of opioid use on thromboembolic complications, readmission rates, and 90-day episode of care costs after total hip arthroplasty. J. Arthroplasty. 2020;
35(6S):S237–S240.doi: 10.1016/j.arth.2020.02.014
NiadaFTabinRKayemba-Kay’sS.Spontaneous neonatal renal vein thromboses: should we treat them all? A report of five cases and a literature review.Ped Neonatology. 2018;
59(3):281–287. doi:10.1016/j.pedneo.2017.09.009
6.
NiestersMOverdykFSmithTAartsLDahanA.Opioid-induced respiratory depression in paediatrics: a review of case reports.Br J Anaesth. 2013;
110(2):175–182.
7.
CohenMCMorleySRCoombsRC.Maternal use of methadone and risk of sudden neonatal death.Acta Paediatr. 2015;
104(9):883–887.
8.
GiacchettiLDe GaudenziMLeonciniAFerrucciEPezzoliVAlbisettiM.Neonatal renal and inferior vena cava thrombosis associated with fetal thrombotic vasculopathy: a case report.J Med Case Reports. 2017;
11:248. doi:10.1186/s13256-017-1414-0
9.
van der SchierRRoozekransMvan VelzenMDahanANiestersM.Opioid-induced respiratory depression: reversal by non-opioid drugs. F1000Prime Rep. 2014;
6:79. doi:10.12703/P6-79
