The effect of intrapartum magnesium sulfate therapy on fetal cardiac troponin I levels at delivery

Abstract

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. Study design: 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 ≥ 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.

• TROPONIN
• MAGNESIUM SULFATE
• FETAL CARDIAC ENZYMES