Evaluation of total LDH and its isoenzymes as markers in preeclampsia.

Rimsha Saleem Fazal,Swetha Chandru,Monalisa Biswas

doi:10.2478/jomb-2019-0045

Abstract

Preeclampsia, a rapidly progressing pregnancy-specific multi-systemic syndrome is globally the leading cause of maternal and neonatal morbidity and mortality. This study aims to evaluate the serum total Lactate dehydrogenase levels in women with preeclampsia when compared to normotensive pregnant women and assess the electrophoretic pattern of the LDH isoenzymes in normal pregnancy, preeclampsia and eclampsia. The study, carried out in the Department of Biochemistry of MVJ Medical College, included 30 patients of preeclampsia and 30 normotensive gestational age-matched pregnant women admitted to the Department of OBG. Serum total LDH was analysed by DGKC method. Serum and cord blood samples for isoenzyme distribution analysis were collected from a normal pregnant woman undergoing delivery, a woman with mild eclampsia, two women with eclampsia, and analysed by slab gel electrophoresis followed by activity staining. LDH was significantly elevated in cases as well as between the case (mild and severe) groups, showed a moderate positive statistically significant correlation with systolic, diastolic blood pressure and a sensitivity of 50% and a specificity of 80%. Further, the isoenzyme pattern showed a decreasing distribution of aerobic forms of LDH in preeclampsia-eclampsia. Serum total LDH may serve as a robust and affordable marker of preeclampsia. Serum total LDH, along with its isoenzyme profile, might serve as a predictor and a stronger marker of preeclampsia when compared to serum LDH analysis alone. It may also be used to assess the severity of preeclampsia and hence help in predicting and preventing adverse maternal and foetal outcomes.

Highlights

Preeclampsia is defined as a pregnancy-specific multi-systemic syndrome of widespread endothelial malfunction and vasospasm developing after 20 weeks of gestation [1,2,3]
Serum total lactate dehydrogenase (LDH), along with its isoenzyme profile, might serve as a predictor and a stronger marker of preeclampsia when compared to serum LDH analysis alone
It may be used to assess the severity of preeclampsia and help in predicting and preventing adverse maternal and foetal outcomes

Summary

Introduction

Preeclampsia is defined as a pregnancy-specific multi-systemic syndrome of widespread endothelial malfunction and vasospasm developing after 20 weeks of gestation [1,2,3]. It is a rapidly progressive condition traditionally defined by increased blood pressure (140/90 mm Hg), fluid retention and proteinuria [4]. The ACOG revised guidelines define preeclampsia as a de-novo and abrupt onset persistent hypertension associated with proteinuria or pathological edema or thrombocytopenia or impaired liver or kidney function or new onset of cerebral or visual disturbances [1, 5]. In India, the incidence of preeclampsia is 8% to 10 % among pregnant women [8]

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