Report on intrauterine drug exposure during second trimester of pregnancy in a heroin-associated death.
A 17-year-old girl was found dead in a public toilet with fresh needle puncture marks. She was 18-20 weeks pregnant with a male fetus. Drug screening of her blood and urine indicated recent heroin use. Chronic drug use was confirmed by hair analysis. Amniotic fluid as well as fetal and maternal tissues and body fluids were analyzed by GC/MS and HPLC. All the fetal specimens were investigated, and the following levels of drugs were found: 6-monoacetyl-morphine (blood: 152 ng/g; amniotic fluid: 128 ng/g; brain: 140 ng/g; lung: 110 ng/g; liver: 2 ng/g; kidney: 40 ng/g), morphine (blood: 1360 ng/g; amniotic fluid: 604 ng/g; brain: 710 ng/g; lung: 1030 ng/g; liver: 2060 ng/g; kidney: 1100 ng/g), codeine (blood: 70 ng/g; brain: 60 ng/g; lung: 60 ng/g; liver: 90 ng/g; kidney: 70 ng/g), and morphine-3-glucuronide (amniotic fluid: 209 ng/g; brain: 170 ng/g; lung: 325 ng/g; kidney: 231 ng/g). Morphine-6-glucuronide was present in the maternal circulation but could not be detected in the fetal circulation.
Pötsch
L
L
Institute for Legal Medicine, Johannes Gutenberg University, Mainz, Germany.
Skopp
G
G
Emmerich
T P
TP
Becker
J
J
Ogbuhui
S
S
D000293:Adolescent; D000653:Amniotic Fluid / Q000737:chemistry; D001344:Autopsy; D001826:Body Fluids / Q000737:chemistry; D003061:Codeine / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D005333:Fetus / Q000737:chemistry / Q000378:metabolism*; D008401:Gas Chromatography-Mass Spectrometry; D006197:Hair / Q000737:chemistry; D003932:Heroin / Q000378:metabolism* / Q000506:poisoning*; D006801:Humans; D008297:Male; D008431:Maternal-Fetal Exchange; D009022:Morphine Derivatives / Q000032:analysis; D009293:Opioid-Related Disorders / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000378:metabolism*; D011262:Pregnancy Trimester, Second; D014018:Tissue Distribution
D009022:Morphine Derivatives; C035349:morphine-6-glucuronide; D003932:Heroin; D003061:Codeine