Meconium analysis

The auditory brainstem responses (ABR) in neonates who were exposed prenatally to cocaine showed prolonged absolute peak latencies compared with non-exposed neonates and may indicate compromise of the auditory system from gestational exposure to cocaine (333). Among 58 infants studied, 21 (36%) were positive by meconium analysis for cocaine, and five (8.5%) were also positive for cannabinoids. There were significant differences in mean maternal age, gravidity, parity, birth weight, and head circumference among cocaine-exposed infants. 

Although hair and meconium exhibited essentially identical detection rates, we believe that the clinical significance of the data are not identical. For one, meconium analysis allows the detection of drug use only after birth, whereas analysis of the mother s hair during pregnancy facilitates intervention and reduction of risk to the... 

Comparison of Hair Analysis with Meconium Analysis and Self-Reports... 

Lewis DE, Moore CM, Leikin JB, KoUe, A. Meconium analysis for cocaine a validation study and comparison with paired urine analysis. J Anal Toxicol 1995 19 148-50. 

The standard urine immunoassay for detection of cocaine (23a) abuse during the gestation period of newborn babies was frequently found to yield negative results in cases where positive results were shown by extraction of meconium with a solvent, followed by HPLC. The drug and metabolites such as norcocaine (23b) and cocaethyline (23c) were detected140. See Section IV.C for an alternative analysis of cocaine. 

The potential role of the RIA technique in the analysis of BAs was investigated some time ago in a study about the development of a method for the detection of 3/I-hy-droxy-5-cholenoic acid [41]. This technique was considered by the authors to be important in the evaluation of oxidation of the cholesterol side chain, a minor pathway of BA biosynthesis. 3/THydroxy-5-cholenoic acid was found in human meconium [42] and in amniotic fluid [43], suggesting an important role in foetal life. In healthy subjects this compound was found in urine [44] but not in serum [45]. The kidney probably excretes it and its serum concentration is too low to be detected. The aim of this report was to provide a new method for the investigation of the role of 3/T hydroxy-5-cholenoic acid in cholestatic disease. 

A systematic review of the use of misoprostol for induction of labor has been published (16). The meta-analysis included all randomized clinical trials registered in the Cochrane Pregnancy and Childbirth Group. Vaginal misoprostol was associated with increased uterine hyperstimulation, both without fetal heart changes (RR = 1.67 Cl = 1.30, 2.14) and with associated fetal heart rate changes (RR = 1.45 Cl = 1.04, 2.04). There was also an increase in meconium-stained amniotic fluid (RR = 1.38 Cl = 1.06,1.79). 

Ostrea, E. M., Comparison of hair analysis and meconium in detecting drug use during pregnancy. 

Hounsell EF, Lawson AM, Feeney J, Gooi HC, Pickering NJ, Stoll MS, Lui SC, Feizi T. Structural analysis of the O-glycosidically linked core region oligosaccharides of human meconium glycoproteins which express oncofetal antigens. Eur. J. Biochem. 1985 148(2) 367-377. 

The analysis of cocaine and some of its metabolites in meconium and human urine was reported [86-88]. The analysis in mecoiuum was directed at finding an appropriate diagnostic marker for neonatal cocaine exposure [86]. For human urine analysis of these basic compounds, the use of a pentafluorophenylpropyl rather than a C,8 column has been proposed 12-fold better signals were obtained due to the improved peak shape [88]. In most cases, ESI ionization in combination with SRM is applied. Typical limits of quantification are in the range of 1-5 ng/ml or ng/g. 

Whereas meconium is more easily collected from newborns than urine, it is considerably more difficult to analyze. Meconium is a heterogeneous, gelatinous material from which drugs must be extracted before analysis by immunoassay and confirmation by GC-MS.It should be noted that drug extraction fi om meconium using inorganic acids, methanol, or any other alcohol is protected by U.S. patents. ""- ... 

ElSohly MA, Stanford DF, Murphy TP, Lester BM, Wright LL, Smerigiio VL, et al. Immunoassay and GC-MS procedures for the analysis of drugs of abuse in meconium. J Anal Toxicol 1999 23 436-45. 

Feng S, ElSohly MA, Salamone S, Salem MY (2000) Simultaneous analysis of delta-9-THC and its major metabolites in urine, plasma, and meconium by GC-MS using an immunoaffinity extraction procedure. J Anal Toxicol 24 395-402... 

Human exposure to phthalates is most commonly measured by chemical analysis of urine to detect monoester and oxidative metabolites (Silva et al. 2007). Table 2.2 lists the common metabolites for biomonitoring major phthalates. Phthalates are ubiquitous in the environment and also in sample collection and laboratory equipment, so great care is required to produce valid measurements. The most reliable exposure biomarkers are monoesters and oxidative metabolites in urine. Measurements of the parent compound are vulnerable to contamination from laboratory or sampling equipment. Additionally, hydrolytic enzymes found in blood, breast milk, and other biologic matrices like amniotic fluid and meconium, but not... 

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