Background: LDH is an intracellular cytoplasmic enzyme. It is ubiquitous to all the major organ systems. Cellular enzymes in extracellular space have no metabolic function, although they serve as indicators of disturbances in cellular integrity. Serum LDH is abnormal in many disorders, therefore total serum LDH is highly sensitive but nonspecific test. In preeclampsia also LDH may be elevated and can indicate the prognosis for both mother and fetus. We conducted this study to examine the relationship between lactate dehydrogenase concentration and the severity of the disease and the occurrence of its complications.Methods: 200 pre-eclamptic women (121 with mild and 79 with severe pre-eclampsia) and 200 healthy normotensive controls were studied prospectively at Government Kilpauk medical college and hospital between January and December 2015. Demographic, hemodynamic, and laboratory data were compared among the three groups. The symptoms and complications of severe pre-eclampsia along with fetal outcome were analyzed according to the levels of LDH.Results: Severely pre-eclamptic patients were significantly younger, with low gravidity and parity. On the other hand, they had significantly increased systolic and diastolic pressure and liver enzymes, uric acid, urine albumin, and LDH levels. The symptoms and complications of pre-eclampsia along with perinatal mortality were increased significantly in patients with LDH >800 IU/l compared with those who had lower levels.Conclusions: Lactate dehydrogenase is a useful biochemical marker that reflects the severity of pre-eclampsia. In our study, LDH has been evaluated as a biochemical marker for preeclampsia and as a prognosticator of the disease severity. Detection of high-risk patients with increased levels of LDH mandate close monitoring and management to prevent maternal and fetal morbidity and mortality.
Intrauterine growth restriction (IUGR), a condition in which the foetal growth is restricted pathologically in utero, remains a serious health problem. The main aim of this study was to evaluate the effect of L-Arginine administration on the fetal outcome in pregnancies complicated by intra uterine growth restriction. Methods: This randomized control study was undertaken in the Department of Obstetrics and Gynaecology at Government Kilpauk Medical College and Hospital, Chennai from March 2017 to August 2017. The study included 60 randomly chosen pregnant women diagnosed with intrauterine growth restriction (IUGR). 30 women received 3 g of L-Arginine daily as a supplement to standard therapy (case group) and 30 women received only routine therapy (control group). The ultrasound and clinical examination were done on the first day of hospitalization and then every week in both the groups. Results: In the group treated with L-Arginine, we observed higher Estimated fetal weight after 4 weeks of treatment (p <0.05), higher birth weight at delivery (p < 0.05), and APGAR score at 5 minutes (p < 0.05) compared to control group. There were no significant differences in IUGR (at entry and at delivery) between two groups. We also observed that there was an improvement in the liquor status of the group treated with L-Arginine (p<0.05). Conclusion:Our study demonstrated that L-Arginine administration to pregnant women with IUGR may improve fetal condition and neonatal outcome after delivery by prolonging pregnancy and delivering a child with higher birth weight, better APGAR score and decrease the rate of cesarean sections. However, these benefits require confirmation by larger, more-powered study.
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