Meconium drug screen

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For any infant with signs or symptoms that suggest potential substance exposure, the meconium that infant passes should be saved.  A urine drug screen is rapid and inexpensive and is the test of choice if the infant is < 48 hours old.  However, if the urine drug screen is negative and clinical suspicion persists, a meconium drug screen should be sent.  A properly collected meconium screen can detect evidence of maternal drug usage as remotely as 20 weeks of gestation.

            To properly collect a specimen for meconium drug screening, all of the meconium the infant passes must be collected.  Each specimen should be collected in a non-sterile specimen container and sealed.  It is imperative that these specimens NOT be confused, so the nurse should label the sample with the patient’s name, seal it, and initial it at the patient’s bedside.

            The specimens should be stored in the refrigerator in the biohazard room.  Each patient will have a specimen bag to store samples in. The nurse should notify the MD when the patient has begun passing transitional stools.  Once all the meconium has been collected, the sample should be combined, stirred, and sent to the lab.  The case managers should be notified that the screen has been sent.  They will follow up on the results even if the results are outstanding at the time of discharge.

Special considerations:

The specimen must be wrapped in aluminum foil to shield it from light if LSD is to be detected.

The meconium EtOH screen is still too unreliable for clinical use (excessive false positives.)

Discussed at the Nursery Policy & Procedure meeting 9/20/00.

Reference:

Lester BM, ed. Prenatal Drug Exposure and Child Outcome. Clinics in Perinatology 1999; 26:1.