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Re: methFrom: Mary C Burke (trinityrn@sbcglobal.net)Wed Aug 24 20:14:13 2005
I am responding to this kind of late, but I wanted you to know that there is a great article in one of the August '05 Newsweeks' that has a fantastic article on crystal meth. I had heard about it from one of the docs I work with, then found it myself. I learned a lot about it. Illinois has mandatory reporting. I was suspicious about a pt that was delivered at 30 weeks, positive for amphetamines. Her doc said it was sudafed. Sudafed will show a positive amphetamine in the urine. Just thoughts. Mary Kay Burke RN Labor and Delivery Babycatchers@aol.com wrote: The list has been so helpful in the past, I am hoping someone may have had this problem before. At 1 am I had a laboring woman come in at 38 weeks. On AROM she had thick, particulate meconium fluid. The FSE showed decreased to minimal variability, but the baby did respond to scalp stim. She progressed from 5 to complete in just a few minutes. Apgar 8/8, but hyper moro. She had an epidural, so I sent off a urine for an RDS. I thought maybe crack. It came back positive for meth. The baby came back positive for meth too. We have a mandatory reporting system here in WV. The social worker does not believe that my gut just said this fluid was not usual for a 38 week baby. The tracing wasn't horrible, but it didn't look happy either. The mother did not have any real drug behaviors that I saw during PNC. (no sores, no jitteriness, no tracks). When I told her about the positive screen the only thing she asked was that I not tell her family. My backup doc is out of town for another 2 weeks and the covering doc in the next town is not one that I can call and ask questions. So maybe one of you can enlighten me. I have had no experience with meth and pregnancies. From my research it is nasty stuff. Crack plus.... Does anyone know how long it stays in the system? What should I have been looking for? The baby was jittery, but would soothe and stop crying. She says she was in the house when someone else was 'cooking' it. Would that be enough to cross the placenta and make the baby positive? I know the ped got a CBC on the baby. Is there anything different I should do with mom's postpartum care? (Except get her into treatment.) Thanks for any information. Vicki Vicki Smith, CNM Midwives-changing the world one baby at a time. Mary Kay Burke Trinity Nurse Consultants
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