Intravenous injection of heroin during pregnancy exposes the mother and her fetus to a greater risk for which maternal-fetal complication?

• A. Acute bacterial endocarditis
• B. HELLP syndrome
• C. Postpartum hemorrhage
• D. Deep vein thrombosis

Answer: (A)

Intravenous drug use introduces bacteria directly into the bloodstream, creating bacteremia that can seed the heart valves. In heroin users this often leads to acute bacterial endocarditis, an infection that can rapidly damage valves, cause heart failure, and drive systemic infection. During pregnancy, maternal endocarditis poses serious risks to both mother and fetus through hemodynamic instability and potential septic emboli that can affect placental perfusion and fetal well-being. The other conditions listed are not as directly linked to IV drug use in pregnancy, making endocarditis the most likely maternal-fetal complication in this scenario.