Abstract
While the use of cocaine in pregnancy continues to be a significant contributor to adverse maternal and perinatal outcomes, systematic study of the physiologic effects of cocaine in human gestation remains difficult. In a case of acute cocaine intoxication in the third trimester, Doppler velocimetry suggested a physiologic response from the uterine artery but not the umbilical artery. Furthermore, the abnormal uterine artery velocimetry was associated with a positive nonreactive contraction stress test, which became negative and reactive as the effects of the cocaine wore off and the velocimetry returned to normal. These observations suggest that the uterine arteries are more sensitive to cocaine than are the umbilical arteries and that abnormal fetal heart rate patterns during acute cocaine intoxication may be transitory.