Role of serum LDH in preeclampsia as a prognostic factor – a cross sectional case control study in tertiary care hospital

Abstract

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.

To study the correlation of serum lactate dehydrogenase (LDH) levels in women with preeclampsia on maternal and perinatal outcome

“…In the present study, age of most pregnancies occurred in the age group of 20-30 years and mean age was 23.52±2.85 in all the three groups and which was similar to the studies done earlier by Talwar P et aland Mary VP et alwhere majority of the patients belonged to younger age group [8,9].…”

Evaluation of total LDH and its isoenzymes as markers in preeclampsia

“…Studies show high serum LDH levels correlate well with the severity of the disease and outcomes in patients of preeclampsia (10,14,15). A study carried out by Mary et al (16) also suggests increased serum levels of LDH, uric acid and liver enzymes in severe preeclampsia and infers that LDH values greater than 800 U/L correlates with increased risk of perinatal mortality. Further, a study by Purnima and Sonal and another study by Munde et al (18) also concludes that LDH can be effectively used as a biochemical marker as it reflects the severity of preeclampsia and may be helpful in its effective management (17,18).…”

Assessment of Laboratory Derangements in Preeclampsia: Revisiting Traditional Biomarkers

“…Study done by Vinitha Padmini Mary et al also suggests increased serum levels of LDH, uric acid and liver enzymes in severe preeclampsia and infers that LDH values greater than 800U/L correlates with increased risk of perinatal mortality [30]. Further, a study by Purnima and Sonal and another study by Munde et al also concludes that LDH and GGT can be effectively used as biochemical markers as it reflects the severity of preeclampsia and maybe helpful in its management [31,32]. Neha V Bhave further claims that LDH effectively predicts maternal and perinatal outcomes along with the severity of the disease [17].…”