Meconium Testing for Fetal Alcohol Exposure

 

Fetal Alcohol Syndrome, Causes, Signs and Symptoms, Diagnosis and Treatment.

Video taken from the channel: Medical Centric


 

Pre-Natal Exposure Screening Tools: The Maternal History Guide and Meconium FAEE Testing

Video taken from the channel: Children’s Healthcare Canada


 

The Ethics of Meconium Testing as Part of a Screening Toolkit for FASD

Video taken from the channel: Children’s Healthcare Canada


 

Fetal Alcohol Screening with Carol Wallman

Video taken from the channel: USDTL


 

NE Indiana hospitals turn to umbilical cords to test for newborn drug exposure

Video taken from the channel: WANE 15 News


 

Meconium Testing to Determine Alcohol Exposure Dr. Gideon Koren

Video taken from the channel: PreventionInstitute1


 

Meconium Screening to Detect Heavy Fetal Alcohol Exposure

Video taken from the channel: Children’s Healthcare Canada


Meconium can also be tested for drug exposure. Doctors said a positive test does not guarantee that the newborn will suffer from fetal alcohol syndrome symptoms, but can give healthcare providers a head start on providing intervention services for those who are affected. Why Early Intervention Services Are Key. Meconium fatty acid ethyl esters (FAEEs) are validated biomarkers of fetal alcohol exposure. Meconium FAEE testing can potentially be used as a screen by health-care professionals to identify neonates at-risk for Fetal Alcohol Spectrum Disorder, thereby permitting diagnostic follow-up of these children and early intervention in those who develop disabilities.

Immediate intervention services to the alcohol exposed newborns may be provided through early diagnosis by testing the neonatal specimens. Meconium, one of the specimens of choice, begins formation in fetal intestine between 12 and 16 weeks of pregnancy. It can accumulate ethyl alcohol metabolites, which have been sought as direct PAE biomarkers. It has been suggested that measurement of FAEE in meconium has the potential to be a biomarker for prenatal alcohol exposure and, thus, Fetal Alcohol Spectrum Disorder (FASD) and researchers have been studying this relationship since the late 1990s. (1-3) Despite the promise, there are some limitations.

Meconium testing has been suggested as a novel approach to early identification and therefore intervention for Fetal Alcohol Spectrum Disorder (FASD), a set of characteristics associated with prenatal alcohol exposure leading to life-long developmental health impacts. Fetal alcohol exposure can be assessed either retrospectively by directly asking mothers or reliable informants through structured interviews and screening questionnaires or actually by measuring biomarkers of alcohol consumption in pregnancy or in the perinatal phase. Conversely, the other test suggested, meconium ethylglucuronide (EtG), is 15 years younger than meconium FAEE, and a lot of the data existing for FAEE is missing for EtG.” “This is the first time.

Foundational Meconium Research Heavy in utero ethanol exposure is associated with the use of other drugs of abuse in a high-risk population Potential role of the placenta in fetal alcohol spectrum disorder Prevalence of fetal ethanol exposure in a regional population-based sample by meconium analysis of fatty acid ethyl esters. USDTL was the first laboratory to commercially introduce meconium testing to the market in 1991 and we have been seen as the leaders in newborn toxicology ever since. Meconium contains the amniotic fluid swallowed by the fetus in the last half of pregnancy and is released as the first stools after birth.

Meconium is easier to collect than neonatal urine and provides a much longer window of exposure of up to approximately 20 weeks. The FAEEs ethyl linoate, ethyl palmitate, ethyl linoleate, ethyl stearate, and ethyl arachidonate have been suggested as biomarkers in meconium [79–81]. The sum of FAEEs above a cutoff of 2 nmol/g or 50 ng/g meconium was recommended as evidence of maternal alcohol use [68, 82].

List of related literature:

Infants exposed to alcohol in utero may demonstrate withdrawal symptoms after birth such as hyperactivity, excessive crying, irritability, weak sucking, disturbed sleep, tremors and seizures.

“Anatomy and Physiology for Midwives E-Book” by Jane Coad, Melvyn Dunstall
from Anatomy and Physiology for Midwives E-Book
by Jane Coad, Melvyn Dunstall
Elsevier Health Sciences, 2011

Clinicians may be alerted to prenatal alcohol exposure through maternal self-report, maternal intoxication during provider contacts or blood alcohol testing performed on the mother within hours of alcohol ingestion.

“Child Abuse and Neglect E-Book: Diagnosis, Treatment and Evidence” by Carole Jenny
from Child Abuse and Neglect E-Book: Diagnosis, Treatment and Evidence
by Carole Jenny
Elsevier Health Sciences, 2010

This may hasten the course of labour and it allows recognition of meconium staining of the liquor, which is important in the diagnosis of fetal distress.

“Manual of Obstetrics E-book” by Daftary, SUDIP Chakravarti, Muralidhar Pai, Prahalad Kushtagi
from Manual of Obstetrics E-book
by Daftary, SUDIP Chakravarti, et. al.
Elsevier Health Sciences, 2015

A urine and meconium test for toxicology should also be obtained.

“Merenstein & Gardner's Handbook of Neonatal Intensive Care E-Book: An Interprofessional Approach” by Sandra Lee Gardner, Brian S. Carter, Mary I Enzman-Hines, Susan Niermeyer
from Merenstein & Gardner’s Handbook of Neonatal Intensive Care E-Book: An Interprofessional Approach
by Sandra Lee Gardner, Brian S. Carter, et. al.
Elsevier Health Sciences, 2020

Infants born to mothers who chronically ingested alcohol throughout pregnancy up until delivery may also show signs consistent with intoxication and postnatal withdrawal, such as restlessness, excessive mouthing, inconsolable crying, tremors, abnormal reflexes, and hypertonia.

“Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant” by Richard J. Martin, Avroy A. Fanaroff, Michele C. Walsh
from Fanaroff and Martin’s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant
by Richard J. Martin, Avroy A. Fanaroff, Michele C. Walsh
Elsevier Health Sciences, 2010

In order to facilitate the early identification and intervention of infants who may be affected by alcohol exposure in utero, the frequency and the amount of maternal alcohol consumption should be recorded in the child’s health documents [21].

“Neonatology: A Practical Approach to Neonatal Diseases” by Giuseppe Buonocore, Rodolfo Bracci, Michael Weindling
from Neonatology: A Practical Approach to Neonatal Diseases
by Giuseppe Buonocore, Rodolfo Bracci, Michael Weindling
Springer Milan, 2012

No laboratory tests are available for clinical use to quantify the extent of alcohol exposure during fetal life.

“Avery's Diseases of the Newborn E-Book” by Christine A. Gleason, Sherin Devaskar
from Avery’s Diseases of the Newborn E-Book
by Christine A. Gleason, Sherin Devaskar
Elsevier Health Sciences, 2011

Meconium Meconium evaluation is a reasonably soft marker for potential fetal oxygen deprivation.

“Clinical Maternal-Fetal Medicine” by Hung N. Winn, John C. Hobbins
from Clinical Maternal-Fetal Medicine
by Hung N. Winn, John C. Hobbins
Taylor & Francis, 2000

In a controlled trial, Cole and colleagues162 significantly reduced the incidence of meconium-stained liquor by inducing at 39 to 40 weeks’ gestation, but no effect on perinatal mortality or respiratory disease was seen.

“High Risk Pregnancy E-Book: Management Options Expert Consult” by David K. James, Philip J. Steer, Carl P. Weiner, Bernard Gonik
from High Risk Pregnancy E-Book: Management Options Expert Consult
by David K. James, Philip J. Steer, et. al.
Elsevier Health Sciences, 2010

Close fetal monitoring and observation of the liquor for meconium during labour are imperative.

“Mayes' Midwifery E-Book: A Textbook for Midwives” by Sue Macdonald
from Mayes’ Midwifery E-Book: A Textbook for Midwives
by Sue Macdonald
Elsevier Health Sciences, 2011

Oktay Kutluk

Kutluk Oktay, MD, FACOG is one of the world's foremost experts in fertility preservation as well as ovarian stimulation and in vitro fertilization for infertility treatments. He developed and performed the world's first ovarian transplantation procedures as well as pioneered new ovarian stimulation protocols for embryo and oocyte freezing for breast and endometrial cancer patients.

Mail: [email protected]
Telephone: +1 (877) 492-3666

Biography: https://medicine.yale.edu/profile/kutluk_oktay/
Bibliography: oktay_bibliography

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  • how long does drugs stay in the placenta or maconium for, and how long? my friend she says she took half an ecstasy tablet at 7months… she said she dont know why she took it and i know she split from babys dad and i have been here for her. now shes really worried about it and keeps asking me to help her find some info regarding it?..