Журнал клинических случаев

Serum lactate dehydrogenase levels in pre-eclampsia and its correlation with maternal and fetal outcome

Abstract

Nandini.G

Background:

Hypertensive disorders are one of the most common medical disorders during pregnancy.It is a major cause of maternal& perinatal morbidity & mortality. In developing countries, they rank second only to anemia with approximately 7 to 10% of all pregnancies complicated by some form of hypertensive disorders. Identifying high risk patients & close monitoring can  reduce the complications. Lactate dehydrogenase is a useful biochemical marker &can be used to evaluate maternal complications like disseminated intravascular coagulation[DIC], HELLP syndrome,[haemolysis,elevated liver enzymes & lowered platelets] , Pulmonary edema, renal failure & fetal complications like fetal growth restriction[FGR], APGAR score</= 7 at 5 minutes & neonatal intensive care unit[ NICU] admissions.

Objectives:

1. To estimate Serum LDH levels in Preeclampsia patients.

2. To study the correlation between increased serum LDH levels & maternal & fetal outcome.

Methodology:

It was a prospective study at M.S.Ramaiah hospitals from October 2015 - May 2017.

Results:

The incidence of maternal & fetal complications were increased with higher serum LDH levels. With serum LDH > than 600IU/L the incidence of HELLP syndrome was 10% with p value <0.001,**significant, DIC was 1.7% with p value <0.004,**significant, Pulmonary edema was 2.6%, with p value 0.072+significant. It also correlated with increased creatinine levels & decreased platelets with p value < 0.001.** The fetal outcome was FGR in 84.2%, NICU admission in 94.7% and APGAR score <7 at 5 min in 73.6% with p value being statistically significant at 0.001.**

The liver enzymes aspartate aminotransferase [AST] & alanine aminotransferase[ALT] values and serum creatinine were also correlating with increased LDH levels with p value <0.001**.

Conclusion: With raised serum LDH levels, maternal & fetal complications are increased. LDH levels can be used as a biochemical marker. Monitoring of serum LDH levels  helps to achieve a better outcome for both mother and fetus.