Screening for substance use in all pregnant women is recommended by both the American College of Obstetrics and Gynecology (ACOG) and the American Society of Addiction Medicine (ASAM) in order to provide women and their fetuses and children with the best care during and after pregnancy.
Because of the opiate epidemic, many hospitals are routinely drug testing newborns. Fifteen states, including Massachusetts, have laws requiring health care workers to report to authorities if they suspect a woman is abusing drugs during pregnancy.
Consuming drugs in pregnancy is considered child abuse in at least 19 states in the United States, and women can lose custody of their children based on a positive screening test, even without confirmation (Stone, 2015).
Umbilical Cord Testing uses 6 inches of umbilical cord tissue that and has a window of detection up to approximately 20 weeks prior to birth. Umbilical cord blood has the same blood drug detection window as standard blood drug tests, up to approximately 2-3 days prior to collection.
The United States Supreme Court has ruled that hospital workers cannot test pregnant women for use of illegal drugs without their informed consent or a valid warrant if the purpose is to alert the police to a potential crime.
Exposure to maternal drug use during gestation may adversely affect neonatal development and may lead to acute adverse events, including neonatal abstinence syndrome (NAS) and infant mortality. Prenatal drug exposure may also contribute to long-term behavioral effects and developmental deficits.
Meconium begins to form between the 12th and 16th week of gestation. Meconium drug testing can detect maternal drug use during the last 4 to 5 months of pregnancy. A negative result does not exclude the possibility that a mother used drugs during pregnancy.
That’s why at each prenatal visit, you’ll be asked to give a urine sample as part of your regular exam. This sample is used to help determine if you have diabetes, kidney disease, or a bladder infection by measuring the levels of sugar, protein, bacteria, or other substances in your urine.
Three of pregnancy’s more common complications are gestational diabetes, preeclampsia and urinary tract infections — all of which have markers that show up in your urine. That’s why at every prenatal visit, you’ll have to give your doctor a urine sample.
Testing in newborns can be performed on urine, blood, meconium, hair, or umbilical cord blood or tissue samples. Immunoassay screening of urine and blood provide the most rapid results with urine usually preferred due to availability through noninvasive bag specimen collection.
In terms of sensitivity, meconium has previously been considered the best tissue for evaluating fetal drug exposure. As such, there are a large number of methods available for screening across most drug classes, including cocaine, opioids, marijuana, methamphetamine, cotinine, and alcohol use (Wright, 2015).
Sometimes, a home pregnancy test may be positive when a woman isn’t pregnant. Common causes of false-positive results include: Dirty urine collecting cup (detergent residue, for example, is known to cause false-positive results)
A blood test will check for things like: your blood type and Rh factor. If your blood is Rh negative and your partner’s is Rh positive, you may develop antibodies that prove dangerous to your fetus. This can be prevented through an injection given around the 28th week of pregnancy.
Neonatal medical conditions that can be associated with a failure to pass meconium include hypothyroidism, hypercalcemia, hypokalemia, sepsis and congestive heart failure. Hypoganglionosis and neuronal intestinal dysplasia type A can produce symptoms and radiographic findings similar to those of Hirschsprung’s disease.
Preterm infants have been reported to pass meconium in utero as well. However, the reported incidence of meconium-stained amniotic fluid is only 3–6.7% in the preterm population. In full-term infants, it is well established that the in utero passage of meconium indicates an increased risk for adverse outcomes.
Meconium is a newborn’s first poop. This sticky, thick, dark green poop is made up of cells, protein, fats, and intestinal secretions, like bile. Babies typically pass meconium (mih-KOH-nee-em) in the first few hours and days after birth.
Dip Test In A Cup
Most tests instruct you to hold the test under your urine stream, but this is messy and risks error, like not getting enough urine on the test strip. This method also increases the likelihood of the test falling into the toilet by accident.
This is the time of day when your hCG levels will be the most concentrated and easily detected. If you do it at another time of day, try and make sure your urine has been in your bladder for at least four hours. Not drinking excessive amounts of fluids before you take a pregnancy test.
Pee on a Stick or Into the Cup
If you’re peeing into a cup, grab your cup and go. If you’re peeing on a stick, remember to take the cap off the test, if it has one. (This is a very common step people skip when they are nervous.)
You’ll likely have blood work, urine tests, and a glucose tolerance test, too (maybe not the most fun test, but certainly important to screen you for gestational diabetes). You may also choose to get testing for complications in the development of the baby.
Types of Pregnancy Tests
But if you’re like most pregnant women, the only tests you’ll need in your third trimester are the routine screenings conducted at every prenatal visit: a urine test, blood pressure check, measurement of your uterus, and a check of your baby’s heartbeat.
Glucose test for gestational diabetes
This is called ‘gestational diabetes’. Most women are diagnosed using a pathology test, which requires a blood sample to be taken before and after a glucose drink. These tests are usually performed between 26 and 28 weeks into the pregnancy.
Your baby’s first poops are called meconium. It’s a thick and sticky residue that is greenish-black in color. You should see it only in the first 3 days of your baby’s life. The milk your baby swallows heads to their stomach, where acids break it down and it moves into the small intestine.
Failure to pass meconium within the first 48 hours of life in a full-term newborn may be a sign of gastro-intestinal obstructive conditions (such as Hirschprung’s disease, gastro-intestinal malformations, …) or non-obstructive disorders (such as neonatal sepsis, asphyxia, hypothyroidism, …) [3-6].
While babies are unable to fart in the womb, they do produce urine and waste. In fact, according to the American College of Obstetricians and Gynecologists (ACOG), your baby will begin urinating sometime between 13 and 16 weeks gestation, when their kidneys are fully formed.
Meconium is a thick, green, tar-like substance that lines your baby’s intestines during pregnancy. Typically this substance is not released in your baby’s bowel movements until after birth. However, sometimes a baby will have a bowel movement prior to birth, excreting the meconium into the amniotic fluid.
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