Cocaine, fetal loss, and the role of the forensic pathologist

Adverse obstetrical outcomes are often associated with maternal cocaine use. These have included intrauterine growth retardation, abruptio placentae, and an increased incidence of spontaneous abortion and pre-term labor. This report details the case of an 18-week-gestation fetus recovered from a sewage treatment plant. A brain specimen was positive for cocaine. With the present epidemic of cocaine abuse, it is important for the forensic pathologist to seek toxicologic evidence of cocaine in all suspicious fetal and neonatal deaths.