Sign in →

Test ID DASM5 Drugs of Abuse Screen, Meconium 5

Useful For

Identifying amphetamines (and methamphetamines), opiates, as well as metabolites of cocaine and marijuana in meconium specimens

Reflex Tests

Test ID Reporting Name Available Separately Always Performed
AMPHM Amphetamines, Confirmation, M Yes No
COKEM Cocaine and Metabolites, Confirm, M Yes No
OPATM Opiate Confirmation, M Yes No
PCPMC PCP Confirmation, Meconium Yes No
THCM Carboxy-THC Confirmation, M Yes No

Testing Algorithm

Testing begins with immunoassay screen. Positives are confirmed and quantitated by liquid chromatography-tandem mass spectrometry (LC-MS/MS) at an additional charge.

Method Name

Enzyme-Linked Immunosorbent Assay (ELISA)

Reporting Name

Drugs of Abuse Screen, Meconium 5

Specimen Type

Meconium

Chain of Custody is recommended for this test. Chain-of-Custody Meconium Kit (T653) is available upon request.

 

Container/Tube: Stool container (T288)

Specimen Volume: 1 g (approximately 1 teaspoon)

Collection Instructions: Collect entire random meconium specimen.

Additional Information:

1. For chain-of-custody information, see Chain-of-Custody Meconium Kit (T653).

2. Specimen that arrives with a broken seal does not meet the chain-of-custody requirements.

3. The laboratory recommends sending chain-of-custody specimens by overnight shipment.

4. If heroin use is suspected, specimen must be sent frozen to prevent loss of 6-monoacetylmorphine (6MAM, heroin metabolite). When refrigerated, a significant percentage of 6MAM will convert to morphine in <24 hours.

Forms: Chain-of-Custody Request Form is included in the Chain-of-Custody Kit (T653). A copy of this form is also available at http://www.mayomedicallaboratories.com/it-mmfiles/chain-of-custody-request-form.pdf.

Specimen Minimum Volume

0.45 g (approximately 0.5 teaspoon)

Specimen Stability Information

Specimen Type Temperature Time
Meconium Frozen (preferred) 14 days
  Refrigerated  24 hours

Clinical Information

Illicit drug use during pregnancy is a major social and medical issue. Drug abuse during pregnancy is associated with significant perinatal complications, which include a high incidence of stillbirths, meconium-stained fluid, premature rupture of the membranes, maternal hemorrhage (abruption placenta or placenta praevia), and fetal distress.(1) In the neonate, the mortality rate, as well as morbidity (eg, asphyxia, prematurity, low birthweight, hyaline membrane disease, infections, aspirations pneumonia, cerebral infarction, abnormal heart rate and breathing patterns, drug withdrawal) are increased.(1)

 

The disposition of drug in meconium is not well understood. The proposed mechanism is that the fetus excretes drug into bile and amniotic fluid. Drug accumulates in meconium either by direct deposit from bile or through swallowing of amniotic fluid.(2) The first evidence of meconium in the fetal intestine appears at approximately the 10th to 12th week of gestation, and slowly moves into the colon by the 16th week of gestation.(3) Therefore, the presence of drugs in meconium has been proposed to be indicative of in utero drug exposure during the final 4 to 5 months of pregnancy, a longer historical measure than is possible by urinalysis.(2)

Reference Values

Negative

Positives are reported with a quantitative LC-MS/MS result.

Cutoff concentrations

Amphetamines by ELISA: 100 ng/g

Methamphetamine by ELISA: 100 ng/g

Benzoylecgonine (cocaine metabolite) by ELISA: 100 ng/g

Opiates by ELISA: 100 ng/g

Tetrahydrocannabinol carboxylic acid (marijuana metabolite) by ELISA: 20 ng/g

Phencyclidine by ELISA: 20 ng/g

Cautions

Since the evidence of illicit drug use during pregnancy can be cause for separating the baby from the mother, a kit including all the materials necessary to complete chain-of-custody is available to ensure that the test results are appropriate for legal proceedings.

 

If heroin use is suspected, specimen must be sent frozen to prevent loss of 6-monoacetylmorphine (6MAM, heroin metabolite). When refrigerated, a significant percentage of 6MAM will convert to morphine in fewer than 24 hours.

 

Unless sent frozen, cocaine metabolite, m-hydroxybenzoylecgonine, will degrade within 72 hours of collection.

Day(s) Performed

Monday through Saturday

Report Available

2 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. Food and Drug Administration.

CPT Code Information

80301

G0479 (if appropriate)

See individual reflex tests for appropriate CPT codes

NY State Approved

Yes