Evidence of Gestational Heroin Exposure by Comparative Analysis of Fetal and Maternal Body Fluids, Tissues, and Hair in a Heroin-Related Death

Abstract

In order to determine the fetal-maternal distribution of heroin and its main metabolites (6-monoacetylmorphine and morphine) the drug concentrations were measured in autopsy material. The heroin-related death of a pregnant drug abuser (approximately the 32nd week of gestation) provided the fetal and maternal material. Fetal and maternal hair was analyzed in order to obtain long-term information on the transplacental opiate transfer. Morphine and 6-monoacetylmorphine were detected in toxic concentrations in maternal as well as in fetal tissues and body fluids. The drug concentrations in the fetal blood were significantly lower than in the maternal blood. The ratio of fetal-to-maternal (F/M) blood morphine concentration was found to be 0.39, whereas the F/M ratio of 6-monoacetylmorphine in blood was 0.15. In fetal hair analysis, morphine, heroin, and, for the first time, 6-monoacetylmorphine were measured. The resulting F/M ratios were 0.49, 0.36, and 0.6, respectively.

Hair testing is taking root

“…Children living in this type of environment are particularly at risk from exposure to drugs 21,22 and women who continue to use drugs during their pregnancy expose the unborn fetus in the latter months of gestation. 23,24 The role of external contamination has been extensively investigated by researchers who have attempted to recreate various scenarios to mimic possible contamination risks. Drugs have been demonstrated to contaminate drug-free hair exposed to smoke-containing cannabis, 25 bloodcontaining cocaine 26 and from direct application of cocaine 27 to the hair sample.…”

“…Children living in this type of environment are particularly at risk from exposure to drugs 21,22 and women who continue to use drugs during their pregnancy expose the unborn fetus in the latter months of gestation. 23,24…”

Forensic Science

“…Opiates were determined in hair by GC/MS and the results compared to other body fluids (99). Evidence of gestational heroin exposure by comparative analysis of fetal and maternal body fluids, tissues, and hair has been reported in a heroin-related death (100). A preliminary study on the distribution of morphine and its glucuronides in the subcompartments of blood has been reported (101).…”

Neonatal death following clozapine self-poisoning in late pregnancy

“…Many deaths are due to an overdose of prescribed medications [4,5], alcohol and illicit drugs [6][7][8][9][10][11], but they may also be a consequence of poisoning with various other xenobiotics, e.g. pesticides [12][13][14][15].…”

“…In numerous instances, due to doubtless accumulation of the poisonous substance in the fetal organs, poisoning of the mother may lead to fetal death [4,6,9,15,16]. On the other hand, poisoning may be fatal for the mother and -by the same token -for the fetus as well [5,8,10,11].…”