SERUM LACTATE DEHYDROGENASE AS A BIOCHEMIAL MARKER FOR MATERNAL AND PERINATAL OUTCOME IN PRE-ECLAMPSIA

Abstract

Background: Pre-eclampsia affects about 5-10% of all pregnancies and is a major cause of maternal, fetal and neonatal morbidity and mortality, particularly in developing countries. FOGSI and other studies show the incidence of pre eclampsia in India ranges between 11-13%. Lactate Dehydrogenase (LDH) is mainly an intracellular enzyme. LDH is present in many body tissues, especially heart, liver, kidney, skeletal muscle, brain, blood cells and lungs. Its level is increased in the scenario of increased cell injury, hemolysis and cell death. Cellular enzymes in the extracellular space although of no further metabolic function in this space, are still of benet because they serve as indicators suggestive of disturbance of cellular integrity induced by pathological conditions and is used to detect cell damage or cell death.This can be further used as help in making decision, regarding the management strategies to improve the maternal and foetal outcome. Objectives: To compare serum LDH levels in the normal pregnant women and in women with preeclampsia and eclampsia in ante-partum period and to correlate the severity of the disease, maternal and perinatal outcome with Lactic Dehydrogenase (LDH) levels in serum in patients of pre-eclampsia and eclampsia. Material and Methods: A prospective comparative study was conducted in the department of Obstetrics and Gynaecology, Ispat General Hospital, Rourkela. Out of 150 women studied, 50 were normal pregnant women, 32 were of mild preeclampsia, 35 were of severe preeclampsia and 33 of eclampsia. The statistical analysis was done by Chi-square test, Fischer Exact test, analysis of variance and student ''t'' test (two tailed and independent). Results: LDH levels were signicantly elevated in women with preeclampsia and eclampsia (p value <0.001). LDH levels had signicant direct correlation with increasing blood pressure (p value <0.001) as well as poor maternal and perinatal outcome. Conclusion: High serum LDH levels correlate well with the severity of the disease and poor maternal and fetal outcomes in patients of preeclampsia and eclampsia and can be considered as a supportive biochemical and prognostic marker from early third trimester.