Perinatal Drug Testing Lab

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Umbilical Cord Drug Testing

There is little debate that umbilical cord drug testing is the most advanced test available for newborn substance toxicology. We couldn’t agree more, we invented it in 2004, and have the most extensive experience with testing it for in utero exposure to alcohol and substances of abuse.

Like meconium, the umbilical cord belongs to the baby, so there are no issues testing it, and no need for mom's permission. It’s available immediately for 100% of births and needs only 1 collection by 1 collector. This saves time and money, but it also gets the specimen to the lab quicker, so turnaround time is much shorter. The look back is 20 weeks with up to a 13-drug panel option, and alcohol and heroine detection that is superior to any other newborn specimen on the market.

Targeted Collection
Collection of the umbilical cord ONLY if the mother meets the hospital’s conditions for determining a potentially exposed newborn. Click here to view the targeted collection instructions. Click here to view the targeted collection instruction slides.

Universal Collection
Collection and short-term storage of the umbilical cord on ALL newborns. Umbilical cord is sent to the laboratory if the mother meets the hospital’s conditions for determining a potentially exposed newborn, or if the newborn shows signs or symptoms of withdrawal. If neither criteria is met, the umbilical cord is discarded. Click here to view the universal collection procedure instructions. Click here to view the universal collection procedure slides. Click here to download a copy of the Universal Umbilical Cord Collection Log.

Click here to view our collection training video.

Click here to download this information.

Click here to view the Umbilical Cord Resources page.

Drug Panels

  • 13 Panel
  • 12 Panel
  • 9 Panel
  • 7 Panel
  • 5 Panel
Amphetamines
amphetamine, MDA, MDEA, MDMA, methamphetamine
Cannabinoids
carboxy-THC
Cocaine
benzoylecgonine
Opiates
6-MAM, meconin, codeine, hydrocodone, hydromorphone, morphine
Phencyclidine
phencyclindine (PCP)
Methadone
EDDP, methadone
Barbiturates
amobarbital, butalbital, pentobarbital, phenobarbital, secobarbital
Benzodiazepines
alprazolam, diazepam, midazolam, nordiazepam, oxazepam, temazepam
Propoxyphene
propoxyphene, norpropoxyphene
Oxycodone
oxycodone, oxymorphone
Meperidine
meperidine, normeperidine
Tramadol
tramadol
Buprenorphine
buprenorphine, norbuprenorphine
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*Click the green and white plus sign beside each drug class to view the substances within each class.
Add-Ons Available
EtG (Direct Ethanol Biomarker)
ethyl glucuronide
Designer Stimulants (Bath Salts)
mephedrone, methylone, ethylone, butylone, MBDB, mCPP, TFMPP, MDPV
Cotinine
cotinine
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Collection

Collection Instructions

Download PDF

Collection Steps
Cut 6-inch segment
Cut a 6 inch segment of the umbilical cord. This will be the collected specimen.
Drain excess blood
Pinch the specimen between the finger and thumb, then run your fingers down the specimen 3-4 times to drain excess blood. Discard any excess blood.
Rinse exterior of specimen with normal saline or equivalent rinsing solution
Rinse the exterior/outside of the specimen with normal saline or an equivalent rinsing solution. Important: Prevent the umbilical cord and specimen from coming in contact with ethanol-based liquids or vapors previous to and during the collection process. This includes ethanol-based hand sanitizer and alcohol prep pads.
Pat the specimen dry and place it in the specimen container
Pat the specimen dry and place it in the specimen container.
Place the newborn’s ID number on the specimen container
Place the newborn’s ID number on the specimen container (the newborn’s name is optional). The ID number may be the medical record number, hospital laboratory accession number, or any other unique identifying number of the collection facility’s choosing. The hospital patient ID label/sticker may be utilized to satisfy this step.
Fill out the Custody and Control Form
Fill out the Custody and Control Form. Please verify that the pre-printed company information is correct in the Client section of the form:
6a. Place the newborn’s ID number on the Custody and Control Form in the Patient/Donor section (the newborn’s name is optional). A hospital patient ID label/sticker may be utilized to satisfy this step. Enter date of birth and time of birth.
6b. Mark the specimen type box for Umbilical Cord.
6c. Mark the test(s) requested to be performed in the Test(s) Requested section.
Check ALL that apply.
Seal specimen container with tamper-evident seal
The specimen container must be sealed with a tamper-evident seal. Match/verify the newborn’s information on the Custody and Control Form with the newborn’s information on the specimen container. Peel off one of the bar-coded, tamper-evident specimen seals located at the bottom of the Custody and Control Form. Place the bar-coded, tamper-evident seal over the cap. Failure to place a tamper-evident seal over the cap will result in a “Rejected Specimen.”
Initial and date the tamper-evident specimen seal(s)
Initial and date the tamper-evident specimen seal(s).
Print, sign, and date Custody and Control Form
Print, sign, and date in the Collector/Processor Certification section of the Custody and Control Form.
Place Custody and Control Form in specimen bag
Place the original, white copy (Copy 1 LAB Copy) of the Custody and Control Form in the large pouch of the plastic specimen bag provided.
Place specimen container in specimen bag
Place the sealed specimen container in the small pouch of the specimen bag and seal the specimen bag.
Place sealed specimen bag in transport box
Place the sealed specimen bag in the transport box provided.
Place specimen box in transport overwrap
Place the specimen box in an appropriate courier transport overwrap.
Contact Courier
Contact your courier for pick-up. Umbilical cord specimens should be refrigerated in a secure area until they are ready to be shipped.
Client Services

By Phone: 1.800.235.2367

Business Hours (CST)

Monday 6am - 8pm
Tuesday 6am - 8pm
Wednesday 6am - 8pm
Thursday 6am - 8pm
Friday 6am - 8pm

Contact Client Services

Testing Details

Panel Name: Umbilical Cord Testing

Panel Description: Umbilical Cord Testing Drug Panel

Type: Profile

Matrix: Umbilical Cord

Collection Container: Leakproof Polypropylene

Sample Amount: 6-8 inches

Storage Conditions: Refrigerated

Transport Conditions: Ambient

Method: Initial screening test with confirmation of presumptive positives

Turn-Around Time: 1 day for negatives / 2-3 days for positives

  • References
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Can you test for alcohol exposure in umbilical cord?

Yes, alcohol exposure can be tested individually or by adding the Umbilical Cord Testing EtG add-on to any of the Umbilical Cord Testing drug panels. The EtG add-on screens for Ethyl Glucuronide, a direct alcohol biomarker, indicating exposure to ethanol (drinking alcohol).

Does Umbilical Cord Testing use umbilical cord blood or umbilical cord tissue?

Umbilical Cord Testing uses 6 inches of umbilical cord tissue that has been drained and patted dry.

Have results been used in court cases?

Yes, the analysis of a number of tissue types for the presence of drugs of abuse has been used in every state for decades. Specifically, our umbilical cord testing has been used to provide evidence of drug use by the mother in numerous states. Additionally, the detection of drug in umbilical cord was used as evidence of maternal drug consumption in a murder case in South Carolina and that interpretation was upheld on appeal to the SC Supreme Court.

How does using a forensic drug test help the child later in life?

There are several reasons detecting a substance exposed newborn is important. Early detection provides many more options than detection at a later stage in the child’s life, and 

  1. Early detection of fetal alcohol syndrome (FAS) and fetal alcohol effect (FAE) allow newborns to be identified and enrolled into early intervention and community programs. New programs are showing dramatic improvements in children identified earlier in life. 
  2. Detection of a exposed child can allow help, intervention and treatment to be offered to the mother, so that exposure during future pregnancies may be prevented. 
  3. As programs, understanding, and treatments improve, substance exposure detection, at a very early stage, can only help the outcome of the child, mother and family.


How long does the laboratory keep remaining umbilical cord tissue?

Negatives are kept for 1 week, and positives are kept for 1 year.

How should umbilical cord tissue be stored?

The sample is stable at room temperature for 7 days, can be refrigerated (2-8° C) for up to 3 weeks and frozen (< -10° C) up to 1 year.

If the quantity of drug or alcohol metabolite detected is high, could that be an indication that the donor (1) was consuming a large amount, (2) was using recently, or (3) was using frequently?

There are too many variables for anyone to know time of use, dosage, or frequency from the result(s) of a drug test. Reservoir matrices such as hair, fingernail, umbilical cord, and meconium continuously collect drug and alcohol biomarkers. This makes it difficult to determine specific details of use. Because the biomarker is collected over a period of time, the results represent total accumulation that cannot be pin-pointed to specific times/dates/dosages, etc.

Is umbilical cord genetically fetal tissue or tissue of the mother?

The fetus generates umbilical cord during the first five weeks, therefore, it is fetal tissue.

The umbilical cord was fixed in formalin. May it still be used for the Umbilical Cord Testing?

No, Umbilical Cord Testing has not been validated for tissues that have been fixed in formalin.

What is the window of drug exposure for umbilical cord?

Dose/response studies have not been performed and will most likely never be performed for ethical reasons. However, when compared to meconium, which has a detection window of up to 20 weeks, Umbilical Cord Testing has demonstrated an agreement greater than 90 percent.

When will I receive umbilical cord results?

Test  Negative Result Positive Result
Umbilical Cord Drug Panel 1 working day 2 working days
Umbilical Cord EtOH 2 working days 3 working days

Why is Umbilical Cord Testing becoming the gold standard in newborn testing over meconium?

USDTL’s Umbilical Cord Testing is groundbreaking in newborn testing because it solves several problems:

  • Every newborn has an umbilical cord; meconium is not available for every birth.
  • Umbilical cord collection is a one-step procedure; meconium collection requires cumulative collections.
  • Umbilical Cord Testing offers improved positivity rates for Methamphetamine, Benzodiazepines and Opiates.
  • Umbilical Cord Testing improves the integrity of the chain-of-custody: only one donor and one collector are present during the collection. Meconium has multiple collections and multiple collectors.
  • Umbilical Cord Testing improves turnaround time because umbilical cord is ready for transport a few minutes after the birth, while meconium passages can be delayed for days before being sent to the lab.

Why was one matrix positive and another negative on the same donor?

There are several explanations for this. 

  1. Different sample matrices have different detection time frames. The result of any second collected specimen has no bearing on the validity of a first collected specimen. For example, a hair sample with a three month window of detection might test positive for a particular substance, while a urine sample from the same donor, with a 2-3 day window of detection, might test negative. In this case, the donor has used that substance within the past three months, but may not have used it within the most recent three days.
  2. The result of any second collected specimen has no bearing on the validity of a first collected specimen. Therefore, a negative result observed for the umbilical cord does not refute a positive result observed on the maternal urine specimen and the reverse is true as well. There are many legitimate reasons for discrepant urine and umbilical cord results. 
  3. The urine specimen was a screen only result and was not confirmed using an appropriate mass spectrometric method. The screen only urine result is a clinically valid result, however, without an appropriate mass spectrometric confirmation, the urine result has no value in a forensic proceeding. 
  4. Lastly, some placentas can prevent some compounds from reaching the fetus. There are documented cases of maternal ingestion without in utero exposure.

Why was the mother’s urine positive and the umbilical cord negative?

There are several explanations for this. Different specimen types have varying thresholds for positivity. For example, a single dose of methamphetamine 12 hours prior to collection is highly likely to produce a positive urine result, however less likely to generate a positive result for a specimen type with a longer detection window such as umbilical cord, meconium or hair.




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