[Brain-specific creatine kinase (CKBB) in umbilical cord blood. A prognostic parameter in chronic intrauterine hypoxia?].

Elevated levels of brain type creatine isoenzyme (CKBB) have been demonstrated in serum after brain cell injury in neonates. A hypoxic lesion of the membrane permeability of the CKBB rich brain cells may lead to an increased enzyme leakage into the serum. As an increased release from the fetal brain as a result of intermittent compression and decompression of the fetal head during labour and after rupture of membranes may occur without hypoxic damage, only pregnancies which were terminates by cesarean section were studied. No mother went into first stage of labour and no rupture of membranes occurred. Three study groups were defined. The control group (elective cesarean section for breech presentation) showed CKBB enzyme activities below 15 U/l. A group with emergency cesarean sections had low CKBB values too, despite acidotic pH-values (pH < 7.20) at birth. The third group included fetuses which were delivered by cesarean section because of a pathological fetal heart rate tracing and intrauterine growth retardation. 6 out of 40 umbilical cord sera in this group showed elevated CKBB enzyme activities. If there was an additional fetal acidosis an increased neurological morbidity and neonatal mortality was seen.