Drugs of Abuse - Umbilical Cord
Label Mnemonic: UCDAU
Epic code: LAB7758
Downtime form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mailout Laboratory
6240-8 RCP
356-8593
Specimen(s):
Umbilical Cord
(At least 8 inches, approximately the width of a sheet of paper.)
Specimen Instructions:
Drain and discard any blood. Rinse the exterior of the cord segment with normal saline or water. Pat the cord dry and transport at least 8 inches of umbilical cord in a routine urine collection cup or Security Kit for Meconium/Umbilical Drug Detection.
Minimum:
Absolute Minimum: Collect at least 8 inches of umbilical cord.

Premature infants: Send as much as possible - ability to perform full panel of testing related to weight of specimen.
Rejection Criteria:
Cords soaking in blood or other fluid. Formalin fixed. Tissue that is obviously decomposed.
Turn Around Time:
1-3 days upon receipt at reference laboratory
Reference Range:
Drugs covered and range of cutoff concentrations. Note that some 
drugs are identified based on the presence of unique drug metabolites 
not listed below.

Drugs/Drug                                             Range of Cutoff
Classes                                                Concentrations
_______________________________________________________________________

Alpha-OH-Alprazolam, Alprazolam, Benzoylecgonine,         0.5 ng/g
Cocaine, Codeine, Fentanyl, Hydrocodone, Hydromorphone,
Morphine, Norbuprenorphine, Noroxymorphone, Oxycodone,
Oxymorphone, Zolpidem

6-Acetylmorphine, 7-Aminoclonazepam, Buprenorphine,       1 ng/g
Clonazepam, Cocaethylene, Diazepam, Dihydrocodeine, 
Methadone metabolite, Midazolam, m-OH-Benzoylecgonine, 
Naloxone, Nordiazepam, Norhydrocodone, Noroxycodone, 
Phencyclidine (PCP), Propoxyphene, Temazepam

Alpha-OH-Midazolam, Meperidine, Methadone,                2 ng/g
N-desmethyltramadol, O-desmethyltramadol, Oxazepam, 
Tapentadol, Tramadol

Amphetamine, Lorazepam, MDMA (Ecstasy), Methamphetamine   5 ng/g

Phentermine                                               8 ng/g

Gabapentin                                                10 ng/g

Butalbital                                                25 ng/g

Phenobarbital                                             75 ng/g

Marijuana Metabolite will be reported separately          0.2 ng/g
Interpretive Data:
Detection of drugs in umbilical cord tissue is intended to reflect maternal drug use during approximately the last trimester of a full-term pregnancy. The pattern and frequency of drug(s) used by the mother cannot be determined by this test. A negative result does not exclude the possibility that a mother used drugs during pregnancy. Detection of drugs in umbilical cord tissue depends on extent of maternal drug use, as well as drug stability, unique characteristics of drug deposition in umbilical cord tissue, and the performance of the analytical method. Drugs administered during labor and delivery may be detected. Detection of drugs in umbilical cord tissue does not insinuate impairment and may not affect outcomes for the infant. Interpretive questions should be directed to the laboratory.
Methodology:
Qualitative Liquid Chromatography/Tandem Mass Spectrometry
CPT Code:
80326, 80347, 80364, 80355