A 17-year-old pregnant woman, with a history of Tramadol, Methamphetamine, Pregabalin and Chloral hydrate use before and during pregnancy, admitted with severe vaginal bleeding and uterine contraction. An emergent cesarean delivery was performed. Multiple fetal anomalies involving all the body systems were observed, and the fetus passed away seven minutes later. The woman was addicted to four psychological drugs which were Pregabalin, Chloral hydrate, Methamphetamine, and Tramadol before and during pregnancy. Pregabalin is considered the last treatment option for various neurological diseases in pregnant women and more research is required to assess its safety for pregnant women. For Chloral hydrate (CH) the literature hasn’t mentioned any previous study about the teratogenic effect of CH on fetus due to mother intake. With addiction to Methamphetamine, cleft palate and other cognitive, neurological, and behavioral outcomes were observed in many studies. Cardiovascular, gastrointestinal, musculoskeletal and many congenital deformities have been detected among women with tramadol use. To our knowledge, this is the first case that deals with multi-drug use during pregnancy since previous cases were only about one drug.

More research on addiction to more than one of these drugs is desirable to extend our knowledge about their common impact on both the pregnant woman and her fetus.