Coma caused by drug abuse in pregnancy

The incidence of drug abuse and overdosage among women of childbearing age is increasing. The immediacy and clinical urgency of the problem is further emphasized when superimposed on the pregnant state. The case reported herein demonstrates the presentation, clinical course, and successful, conservative management of acute glutethimide overdose with coma in the third trimester. A review of the literature follows, dealing specifically with glutethimide overdose. A discussion of the general guidelines for the treatment of drug overdose is offered including current recommendations and specific management features for glutethimide overdose. The conclusion addresses the implications of conservative versus aggressive management for both mother and fetus as an aid to the practicing obstetrician.