Cord blood cardiac troponin I, fetal Doppler velocimetry, and acid base status at birth

Objective: To analyze the association between umbilical cord cardiac troponin I (cTnl), obstetric Doppler, and birth acidemia. Method: This prospective observational study was conducted on 58 singleton pregnancies at 3 Brazilian hospitals. Umbilical and middle cerebral artery Doppler velocimetry were performed 24 h prior to birth. At delivery, cord blood was collected for pH, blood gas analysis, and cTnl measurement. Results: Cardiac troponin I >= 0.20 ng/mL was detected in 5 neonates (8.6%). Centralization was recorded in 12 fetuses; 4 of these (33.3%) had detectable cTnl compared with 1/46 (2.2%) fetuses with normal Doppler (P=0.005). Acidemia was present in 60% of the neonates with detectable cTnl, compared with 15% of the neonates with undetectable cTnl (P=0.042). Conclusion: Centralization and birth acidemia are associated with detectable cTnl in cord blood supporting the possibility of myocardial ischemia in these fetuses. (c) 2007 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.