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 punc ture 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 co nfirmed by hair analysis. Amniotic fluid as well as fetal and maternal tiss ues and body fluids were analyzed by GC/MS and HPLC. All the fetal specimen s were investigated, and the following levels of drugs were found: 6-monoac etyl-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 n g/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 (amnioti c fluid: 209 ng/g; brain: 170 ng/g; lung: 325 ng/g; kidney: 231 ng/g). Morp hine-6-glucuronide was present in the maternal circulation but could not be detected in the fetal circulation.