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XXXV TIAFT Annual Meeting Poster Presentations
POSTMORTEM TISSUE DISTRIBUTION OF OPIATES IN VARIOUS MATERNAL AND FETAL SPECIMENS AFTER FATAL HEROIN INTOXICATION

Iwersen S., Schmoldt A.

Department of Legal Medicine, Butenfeld 34, 22529 Hamburg, Germany

Background: A 34-year old woman was found dead in her flat. A preliminary examination in our institute showed that a dead fetus (32nd week of gestation) had already been partially expelled. The woman was known to be drug addicted. As the cause of death an acute heroin poisoning was found.
Objective: To determine the tissue distribution between mother and fetus and to retrace the drug consume of the mother over the time of pregnancy by hair analysis. A further question was whether and to what extent a drug consume of the mother could be detected in the fetal hair.
Methods: SPE extraction was performed for body fluids, tissues and hairsegments. Determination of morphine, monoacetylmorphine (MAM) and heroin was achieved with GC-MS.
Results: As will be shown in detail the cause of death was an acute intoxication with extremely high opiate concentrations in blood and brain. High opiate concentrations in the hair of the addicted mother (with detectable amounts of heroin) indicate a continuous heroin abuse during pregnancy. In comparison to the mother the fetus contained lower morphine concentrations of opiates in its blood and hair.
Conclusion: Obviously the placenta protects the fetus against heroin and heroin metabolites. On the other hand the low ratio of bound to free morphine in the bile suggests a low glucuronidation activity of the fetal liver. Therefore fetal morphine levels might decline more slowly and may therefore maintain toxic effects for a longer time.

  Abstract 149

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