Meconium

Meconium is a specimen matrix used exclusively for documentation of in utero drug exposure. Meconium is the a green, viscous material in the newborn's stool during its first 2-3 days of life and it begins to form in the second trimester. Drugs and metabolites are deposited in the meconium either from excretion from the bile or from the fetus's swallowing of amniotic fluid, which contains the compounds eliminated by fetal urine. Thus, meconium, as a waste product of the fetus that accumulates, provides a window of detection of drug exposure that is much longer than that of urine, the latter being a few days from the most recent episode of drug use by the mother. Therefore, meconium testing provides a higher detection rate of fetal drug exposure (15,16). Meconium is easily collected from a diaper and usually available in quantities in excess of minimum amount required for analysis. This is in contrast to urine specimens, which are difficult to collect from newborns in quantities sufficient for screening and confirmation testing. Meconium, being a tarry material, is not easy to handle, particularly in the weighing process, and there are more sample handling steps, including extraction of drugs, before initial testing using standard immunoassays (17).

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