Cardiac troponin in umbilical cord blood in unexplained intrauterine fetal death

Abstract

Background: Troponin T (TnT) is a protein that binds to tropomyosin in cardiac muscle; normally undetectable in serum, it is elevated in adults experiencing myocardial ischemia or infarctions.Objective: To evaluate TnT in umbilical cord blood samples from unexplained intrauterine fetal death and normal pregnancy.Methods: Fifteen cases of unexplained intrauterine fetal death and 15 cases of explained intrauterine fetal death (5 severe preeclampsia, 7 diabetic, and 3 severe cases of chorioamnionitis) were evaluated. Fifty cases of full term pregnancies in labor were enrolled in the study. Arterial and venous umbilical cord blood samples were obtained. Following blood gas analysis, the specimens were frozen and batched assays were later performed in duplicate. TnT levels were determined by a chemiluminescent immunoassay using monoclonal antibodies specific for human cardiac TnT. Elevated TnT, using adult values, was defined as >0.15 ng/dL in either the arterial or venous sample. Data were analyzed using Fisher’s exact test.Results: There was a statistically significant increase of TnT levels in cases of unexplained intrauterine fetal death in comparison to normal pregnancy (P <0.001) and in comparison to known cases of intrauterine fetal death (P <0.05). Increased levels of TnT in known cases of intrauterine fetal death in comparison to normal pregnancy are not of statistical significance (P >0.05).Conclusions: Umbilical artery TnT level is increased in unexplained intrauterine death. This may provide insight into underlying cause of cardiomyopathy as a cause of this condition.