Fetal stress from methadone withdrawal.

A pregnant patient in the midtrimester of pregnancy was begun on a methadone detoxification program. The fetal neurobiologic response was monitored by serial amniotic fluid amines (epinephrine and norepinephrine). The detoxification program showed a marked fetal response of the adrenal gland (E) and sympathetic nervous system (NE) that was blunted when the methadone dose was increased. Detoxification during pregnancy is not recommended unless the fetus can be biochemically monitored.