Estimation of Level of Serum Lactate Dehydrogenase in Pre-eclampsia Patients and its Association with Maternal and Fetal Outcome

Abstract

Introduction: Pre-eclampsia is a pregnancy-specific syndrome recognised as a leading cause of maternal and perinatal mortality. Etiopathogenesis of preeclampsia is defective placentation and endothelial dysfunction leading to oxidative stress and cellular lysis. Lactate Dehydrogenase (LDH) is an intracellular enzyme of glycolysis. Hypoxia and cellular lysis results in elevated levels of LDH. Early detection and management are important in prevention of Preeclampsia complications and deaths. Hence, the present study was conducted to estimate levels of Sr. LDH in Pre-eclampsia patients to find its association with maternal and fetal outcome was undertaken. Materials and Methods: Present prospective study was conducted in Department of Obstetrics and Gynaecology from August 2016 to December 2018 consisting of 84 cases of preeclampsia of ≥28 weeks gestation divided in 2 groups; Mild and Severe Preeclampsia. Sr. LDH was estimated in all study participants and its association with parameters of maternal and fetal outcome was observed. Results: In the present study, 46 patients had Mild Preeclampsia. and 38 had Severe Preeclampsia. Most cases of Mild preeclampsia. i.e., 78.3% had LDH <600 IU/L whereas 71.1% of Severe Preeclampsia. had LDH >600 IU/L. Complications like eclampsia in 66.7%, HELLP in 33.3%, Abruptio placenta in 55.6%, ARF and DIC in 33.3% cases were noted more in patients with LDH >800 IU/L. Fetal still birth in 55.6%, Lower APGAR score and more NICU admission and Early neonatal death was present in babies of preeclampsia mother with LDH >800 IU/L. There was found statistically significant association (p<0.001) of raised Sr. LDH levels with poor maternal and fetal outcome in preeclampsia patients. Conclusion: Elevated levels of Sr. LDH during hypoxia, indicate the cellular damage and dysfunction occurring in preeclampsia. Detection of patients with increased levels of LDH is of crucial importance to detect and promptly manage the complicated cases and decrease the morbidity and mortality in mother and fetus.