Meconium Drug Screen

Aka: Meconium Drug Screen, Toxicology Screening of Meconium

advertisement

II. Indication

  1. Suspected Substance Abuse in Pregnancy

III. Mechanism

  1. Meconium accumulates drug exposure throughout pregnancy
  2. In utero exposure of drugs implied by positive test
    1. Exposure may have been months prior to delivery

IV. General

  1. Lab testing methadology is critical to efficacy
  2. Screening Tests are non-specific
  3. Confirmatory testing is highly specific
    1. Gas chromatography mass spectrometry (GC/MS)
    2. Liquid Chromatography mass spectrometry (LC/MS)

V. Efficacy

  1. False Positives if infant urinates into sample
    1. Reflects antepartum and perinatal esposure
  2. False Negatives
    1. Meconium sample at room Temperature
      1. Decreases Cocaine and Cannabinoid by 25% per day
    2. Preterm Infant

VI. Drug Screening (sensitive, but not specific)

  1. Opiates
    1. May be positive due to Codeine, Heroin, Morphine
    2. Less sensitive for Oxycodone and Hydrocodone
    3. Heroin clears very quickly
      1. However 6-acetylmorphine metabolite clears slowly
  2. Cocaine
    1. Multiple metabolites may be measured
    2. False Positive is very rare
      1. Theororetically Lidocaine can cause positive
      2. In reality, Lidocaine ammount required too high
  3. Amphetamines
    1. Methamphetamine metabolized to Amphetamine
    2. MDMA (Ecstacy) metabolized to MDA
    3. MDA and Amphetamine may appear similar on testing
  4. Cannabinoids (Marijuana)

VII. References

  1. Lesler (2001) Pediatrics 107:309-317 [PubMed]
  2. Ostrea (2001) J Pediatr 138:344-8 [PubMed]

Images: Related links to external sites (from Bing)

These images are a random sampling from a Bing search on the term "Meconium Drug Screen." Click on the image (or right click) to open the source website in a new browser window. Search Bing for all related images

Related Studies

Related Topics in Pathology and Laboratory Medicine

advertisement