Meconium drug screening of stillborn infants: a feasibility study.
OBJECTIVE
Meconium drug testing of liveborn infants is highly sensitive (87%) and specific (100%). Accurate knowledge of drug use in mothers of stillborns would be beneficial. We determined the feasibility of noninvasive meconium drug screening for opiates and cocaine in stillborns.


METHODS
Stillborn infants delivered at our hospital had meconium collected using a 4-mm spatula inserted into the anus. Specimens were analyzed using gas chromatography. Charts were reviewed.


RESULTS
Of the 30 specimens obtained, 26 were below the optimal amount needed (0.5 g). Regardless, all samples were analyzed and three were positive for cocaine (10%), none for opiates. Two of the 3 positive samples were of 'insufficient quantity'. In one, the presumptive cause of fetal demise was diabetes, with no additional factors suggesting substance abuse. The other fetal loss was due to idiopathic preterm labor at 21.5 weeks, with a positive UDS.


CONCLUSIONS
In this pilot study, inability to obtain an optimal volume of meconium occurred frequently. However, important and unexpected laboratory data were generated even with 'insufficient quantity'. This highlights the need to develop more refined methodologies for this screening tool in stillborn fetuses.
Lauria
M R
MR
Department of Obstetrics and Gynecology, Wayne State University, Detroit, Mich., USA.
Qureshi
F
F
Jacques
S M
SM
Kurtzhals
P
P
Ostrea
E M
EM
Gonik
B
B
Sorokin
Y
Y
D000328:Adult; D003042:Cocaine / Q000032:analysis; D005240:Feasibility Studies; D005260:Female; D005313:Fetal Death; D005865:Gestational Age; D006801:Humans; D008470:Meconium / Q000737:chemistry*; D010865:Pilot Projects; D011247:Pregnancy; D012680:Sensitivity and Specificity; D015813:Substance Abuse Detection
D003042:Cocaine