Hospital policy requires meconium testing for all newborns who are suspected of being substance exposed in utero. Substance exposure in utero is of serious concern and is associated with significant perinatal complications for mother and child. In the past, maternal interviews were the primary source of substance use during pregnancy. Maternal interviews can provide health care professionals with critical information although they can be misleading. Not all substance using mothers will willingly admit to, or may minimize, use for a variety of reasons.
There are various methods for testing of substances in newborns, including; blood, urine, hair, and meconium. Disadvantages to neonatal hair and urine sampling are that they detect recent substances and not prolonged exposure, and it is difficult to collect a sample that will be sufficient to test. Furthermore, some substances have been shown to accumulate more in dark hair colors reducing the reliability of generalized testing (Abudu, 2011, n.p.). One large-scale survey between 1988 and 1989 tracked maternal acknowledgment of substance use, urine analysis, and meconium testing in a perinatal center. 11% of the mothers admitted to substance use during pregnancy, 52% of newborns tested positive in a urine drug screen, and 88% had a positive meconium drug screen. A four-fold increase in detection of illicit substances in newborns was found with meconium screening (Ostrea, Brady, Gause, Raymundo, & Stevens, 1992, p. 107). “Meconium is the fecal material passed by the newborn within the first three days of birth. The color is generally dark-green due to the presence of bile pigmentation. It begins to form between 12 and 16 weeks of gestation. Therefore, it can provide a history of in utero drug exposure” (Abudu, 2011, n.p.). Meconium drug screening is a nonintrusive and cost effective way of testing newborns for illicit substances. …show more content…
“Meconium is collected directly from the diaper of the infant… A clean wooden spatula is used to transfer meconium from the diaper to its container. Preferably, meconium should be obtained from two diapers, and the specimens combined to increase the likelihood of a positive test, especially in mothers who are only episodic users of drugs” (Ostrea, 2001, n.p.) Additionally, meconium testing is convenient because it “can be performed by most hospitals clinical laboratories because the methods used for meconium testing are standard methods used in most hospital laboratories” (Ostrea, 2001, n.p.). Meconium screening is not mandatory for all newborn children. …show more content…
Maria’s positive urine drug screen during pregnancy made her newborn child a candidate for meconium screening as it is the testing method preferred by ABC Medical Center. Regardless of the outcome of the meconium test, the social worker would be obligated to refer to Department of Child Safety (DCS) due to the earlier positive urine drug screen and admitting use. Meconium testing at this point would be to assess the frequency, intensity, and duration of substance use. Furthermore, laboratory findings will show the time of gestation substances were used and identify specific substances. Baby Boy Diaz had first meconium in utero, therefore a full meconium drug screen was never completed, but there was still sufficient evidence to warrant the DCS referral. Marijuana is a hotly debated subject in the United States. Some states are pushing towards the legalization of marijuana for medicinal or recreational purposes. As of today marijuana is still considered an illicit substance and is
There are various methods for testing of substances in newborns, including; blood, urine, hair, and meconium. Disadvantages to neonatal hair and urine sampling are that they detect recent substances and not prolonged exposure, and it is difficult to collect a sample that will be sufficient to test. Furthermore, some substances have been shown to accumulate more in dark hair colors reducing the reliability of generalized testing (Abudu, 2011, n.p.). One large-scale survey between 1988 and 1989 tracked maternal acknowledgment of substance use, urine analysis, and meconium testing in a perinatal center. 11% of the mothers admitted to substance use during pregnancy, 52% of newborns tested positive in a urine drug screen, and 88% had a positive meconium drug screen. A four-fold increase in detection of illicit substances in newborns was found with meconium screening (Ostrea, Brady, Gause, Raymundo, & Stevens, 1992, p. 107). “Meconium is the fecal material passed by the newborn within the first three days of birth. The color is generally dark-green due to the presence of bile pigmentation. It begins to form between 12 and 16 weeks of gestation. Therefore, it can provide a history of in utero drug exposure” (Abudu, 2011, n.p.). Meconium drug screening is a nonintrusive and cost effective way of testing newborns for illicit substances. …show more content…
“Meconium is collected directly from the diaper of the infant… A clean wooden spatula is used to transfer meconium from the diaper to its container. Preferably, meconium should be obtained from two diapers, and the specimens combined to increase the likelihood of a positive test, especially in mothers who are only episodic users of drugs” (Ostrea, 2001, n.p.) Additionally, meconium testing is convenient because it “can be performed by most hospitals clinical laboratories because the methods used for meconium testing are standard methods used in most hospital laboratories” (Ostrea, 2001, n.p.). Meconium screening is not mandatory for all newborn children. …show more content…
Maria’s positive urine drug screen during pregnancy made her newborn child a candidate for meconium screening as it is the testing method preferred by ABC Medical Center. Regardless of the outcome of the meconium test, the social worker would be obligated to refer to Department of Child Safety (DCS) due to the earlier positive urine drug screen and admitting use. Meconium testing at this point would be to assess the frequency, intensity, and duration of substance use. Furthermore, laboratory findings will show the time of gestation substances were used and identify specific substances. Baby Boy Diaz had first meconium in utero, therefore a full meconium drug screen was never completed, but there was still sufficient evidence to warrant the DCS referral. Marijuana is a hotly debated subject in the United States. Some states are pushing towards the legalization of marijuana for medicinal or recreational purposes. As of today marijuana is still considered an illicit substance and is