Smoking in pregnancy & imaging in pregnancy (add tables)

Smoking in Pregnancy

Increased the risks of

1.Miscarriage

2. Stillbirth

3. Placental abruption

4. PTB

5. Low birth weight

Depression and smoking

X4 times more

Cigarette smoking contains

4000 compounds including - nicotine, CO and carcinogens

It restricts supply of oxygen and nutrients to baby (affecting its growth and development of brain/lungs)

Smoker is exposed

400-500 ppm Carbon monoxide

BASELINE of Carboxyhaemoglobin of 4% (ranging from 3-8%) VS 1% in non-smoker

As the concentration of carbon monoxide increased

Oxygen-Hb dissociation curve shifts to the left.

This shift impairs the oxygen delivery to the myometrium and fetopacental unit.

Cadmium in cigarette

Associated with fetal growth restriction

Nicotine

Neuto-teratogen

Distrusts neurotransmitter function in fetal brain and alter normal brain development

When to ask about smoking status in pregnant women

At booking

And at regular intervals during pregnancy and puerpureim

When to referral to NHS Stop Smoking services

1. All current smokers

2. Occasional smokers

3. Smokers who have quit in previous 2 weeks

4. CO levels >4

5 As for bride smoking cessation

ASK

ADVISE

ASSESS ( determining willingness to quit smoking)

ASSIST (referral)

Arrange (follow ups, 1 week after quitting date)

Nicotine replacement therapy

Transdermal patches, Lozenges, chewing gum, oral sprays, microtabbs and inhalers.

Transdermal patches -delivery nicotine slowly over the course of a day, others can be faster acting and aim to counter acute cravings.

E-cigarettes - evidence does not permit us much.

Harm from cigarette smoking

Carbon monoxide and tar

Which week should smoking be stopped in pregnancy

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