Lortab and Pregnancy

[bugsmom1]

I am 20 weeks pregnant with a healthy little girl (had CVS and level II ultrasound.)  Everything looks great.  My OB has prescribed lortab for migraines and a neck dystonia (which was previously treated with Botox - but not now due to the pregnancy.)  My question is at low levels of lortab -- less than 10Mg a day (and some days with nothing) would it be safe to assume that the chances of withdrawl or low?  Should I stop taking completely a month before due date?  Finally, given that I took it all through my first trimester, do you think we would have  seen a problem on the Level II if there was one?

Thanks

[Yao Sun, MD, PhD]

Generally speaking, the risk of fetal problems with Lortab are low, and the fact that you've had a normal CVS as well as level II ultrasound is very reassuring.

It is difficult to predict the level of opioid medication that will cause withdrawal symptoms in a newborn baby.  Generally speaking, the lower the dose the better, and stopping the medication prior to delivery will definitely decrease the risk.  If you stopped the Lortab between 1 to 2 weeks before anticipated delivery, the risk of withdrawal would be extremely low (if you deliver at your due date).  You do, however, need to balance your pain treatment with the risk of withdrawal, and the best person to discuss that with is your obstetrician.

[bugsmom1]

Thank you as always.  I do appreciate your help!