The effect of intrapartum magnesium sulfate therapy on fetal cardiac troponin I levels at delivery.
OBJECTIVE
To determine whether intrapartum magnesium sulfate (MgSO4) therapy for seizure prophylaxis in pre-eclampsia-eclampsia is associated with biochemical evidence of subacute fetal myocardial damage at delivery.


METHODS
Troponin I, a cardiac-specific protein used to detect myocardial injury, was measured from the umbilical vein at delivery in term pregnancies complicated by pre-eclampsia and uncomplicated control pregnancies. Women with pre-eclampsia received intravenous MgSO4 as a 6-g load followed by 2 g/hour until delivery. Clinical characteristics and fetal troponin levels were compared between groups.


RESULTS
There was no difference in troponin I concentrations between term patients with intrapartum MgSO4 therapy and controls who did not receive MgSO4 (median 0.86 ng/ml, range 0.72-1.10 vs. 0.89 ng/ml, range 0.68-1.50; p = 1.0). There was also no statistically significant difference in the number of patients with a troponin I level of > or = 1.0 ng/ml between groups (30.8% (4/13) vs. 15.4% (4/26); p = 0.4).


CONCLUSIONS
Our findings suggest that, in term fetuses that are not growth impaired, exposure to intrapartum MgSO4 is not associated with subacute myocardial injury.
Blackwell
S C
SC
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Hutzel Hospital/Wayne State University, Detroit, Michigan 48201, USA.
Redman
M E
ME
Whitty
J E
JE
Refuerzo
J S
JS
Berry
S M
SM
Sorokin
Y
Y
Russell
E
E
Cotton
D B
DB
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D018890:Chemoprevention; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric; D004461:Eclampsia / Q000150:complications / Q000188:drug therapy; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005315:Fetal Diseases / Q000097:blood / Q000139:chemically induced*; D006801:Humans; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D017202:Myocardial Ischemia / Q000097:blood / Q000139:chemically induced*; D011225:Pre-Eclampsia / Q000150:complications / Q000188:drug therapy; D011247:Pregnancy; D012640:Seizures / Q000150:complications / Q000517:prevention & control; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019210:Troponin I / Q000097:blood*
D000927:Anticonvulsants; D015149:Tocolytic Agents; D019210:Troponin I; D008278:Magnesium Sulfate