Assessment of Laboratory Derangements in Preeclampsia: Revisiting Traditional Biomarkers

Abstract

Objectives:To assess the routine laboratory analytes, serum Thyroid Stimulating Hormone (TSH), Lactate Dehydrogenase (LDH) and Uric acid in women with preeclampsia compared to normotensive healthy pregnant women and to determine the concentration of liver enzymes in women with preeclampsia. Materials and Methods: The study was carried out in the Department of Biochemistry of MVJ Medical College and Research Hospital. Thirty women with preeclampsia and thirty normotensive pregnant women admitted to the Department of OBG were recruited for the study. Blood samples were collected and analysed for serum TSH, LDH, uric acid and liver enzymes. Mann Whitney U test was employed to evaluate the significance of the differences obtained between the groups. Results: All three analytes were significantly higher in the case group when compared to controls. LDH and ALT (Alanine transaminase) showed significant difference even within the mild and severe preeclampsia groups. A moderate positive statistically significant correlation (r=0.348, p=0.006) was obtained between serum TSH and LDH. Serum TSH level showed a sensitivity of 66.64%, specificity of 73.33% and a positive predictive value of 71.4%. A De Ritis ratio of 1.82 was observed in preeclampsia. Conclusion: TSH, LDH and Uric acid showed significant elevation in preeclampsia. TSH and LDH levels showed a positive correlation. Hence, TSH, LDH and Uric acid could serve as markers of preeclampsia. A hypothyroid status in early pregnancy might be seen as a risk factor for preeclampsia. An elevated ALT and a high De Ritis might indicate an underlying liver and cardiac compromise in preeclampsia.