Evaluation of serum lactate dehydrogenase as early diagnostic biomarker in pregnancy with preeclampsia and eclampsia

Abstract

Pregnancy is a physiological state associated with many alterations in biochemical, physiological, hematological & immunological processes. Preeclampsia and eclampsia complicate 6-8% of all pregnancies and lead to various maternal and fetal complications. The aim of the present study was to evaluate serum LDH levels in the normal pregnant women and pregnant women with preeclampsia and eclampsia in ante-partum period and to study the correlation of maternal and perinatal outcomes with serum LDH levels.This prospective study was conducted among ANC mothers from 18-35 years with term singleton pregnancy attending OBG OPD and labour room at Navodaya Medical College Hospital & Research Centre, Raichur. After taking informed consent & detailed clinical examination, relevant laboratory investigations were performed. The serum LDH estimated using fully automated ERBA biochemical analyser.In the present study, a total of 200 pregnant women were included, out of which 100 were normal pregnant women which served as control group; remaining 34 (17%) cases were included in pregnancy with eclampsia and 66 (33%) were pregnancy with pre-eclampsia. In 29 cases of study group with Serum LDH in the range of 600-800 IU/L, 08 (27.6%) had severe pre-eclampsia and 18 (62.0%) had eclampsia. Of 34 eclampsia cases, 18(52.9%) had Serum LDH range 600-800IU/L and 14 (41.2%) had serum LDH >800IU/L. The mean Serum LDH in study group was 570.5 IU/L and in control group was 201.5 IU/L. The patients had maternal complications like abruption, PPH, DIC, eclampsia with LDH>600. Neonatal complications like IUGR, fetal distress, neonatal death, LBW, premature birth, IUD were increased with raised LDH. Serum LDH is the earliest marker in blood during hypoxia and oxidative stress. It is raised in cases of pre-eclampsia and eclampsia. Detection of high-risk patients with increased levels of LDH mandates close monitoring, prompt and correct management to decrease both maternal and foetal morbidity and mortality. Estimation of serum Lactate Dehydrogenase can be used as a prognostic marker for preeclampsia and eclampsia.