A retrospective medical record audit of the management of cannabis-related emergency department presentations, hospital admissions and hyperemesis of pregnant women who self-reported non-medicinal cannabis use to a substance use in parenting and pregnancy service

Introduction

Research on cannabis-related hyperemesis and its identification and management during pregnancy is scarce. This study aimed to investigate the management of cannabis-related emergency department (ED) presentations, hospital admissions and hyperemesis of pregnant women who self-reported non-medicinal cannabis use to a substance use in pregnancy and parenting service (SUPPS).

Methods

A retrospective medical record audit was conducted on 75 SUPPS patients who identified cannabis as their primary drug of concern and gave birth between January 2015 and May 2020 in Australia. Their ED presentations and hospital admissions in the 12 months prior to the baby's delivery were examined. A descriptive analysis was conducted.

Results

The patients had 232 ED presentations and 183 hospital admissions. History of cannabis use was identified and documented in 34% of the ED presentations and 53% of the hospital admissions. Screening of current substance use was conducted in 45% of the ED presentations and 53% of the hospital admissions. Withdrawal symptoms were documented in 3% of the ED presentations and 13% of the hospital admissions. Cannabis use status was asked in 36% of the ED presentations and 52% of the hospital admissions. Take home medications were provided in 12% of the ED presentations and 12% of the hospital admissions. Referral to SUPPS was made in 7% of the hospital admissions, but none from ED.

Discussion and Conclusions

Gaps in the management of cannabis-related ED presentations and hospital admissions were identified. Routine substance use screening should be conducted to enable early identification of cannabis use during pregnancy.