MECONIUM DRUG SCREENING OF STILLBORN INFANTS - A FEASIBILITY STUDY

Objective: Meconium drug testing of liveborn infants is highly sensiti ve (87%) and specific (100%). Accurate knowledge of drug use in mother s of stillborns would be beneficial. We determined the feasibility of noninvasive meconium drug screening for opiates and cocaine in stillbo rns. 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 fo r cocaine (10%), none for opiates. Two of the 3 positive samples were of 'insufficient quantity'. In one, the presumptive cause of fetal dem ise was diabetes, with no additional factors suggesting substance abus e. The other fetal loss was due to idiopathic preterm labor at 21.5 we eks, with a positive UDS. Conclusion: In this pilot study, inability t o obtain an optimal volume of meconium occurred frequently. However, i mportant and unexpected laboratory data were generated even with 'insu fficient quantity'. This highlights the need to develop more refined m ethodologies for this screening tool in stillborn fetuses.