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Role of Serum Lactate Dehydrogenase as a Biochemical Prognostic Marker for Pre-eclampsia: A Case Control Study in a Tertiary Care Hospital in South India

Neha Garg, Lalita Ansur and Veena GR

Introduction: Pre-eclampsia is a multisystem disorder specific to pregnancy and puerperium. Lactate Dehydrogenase (LDH), an intracellular cytoplasmic enzyme is ubiquitous to all major organ systems and cells. The central feature of pre-eclampsia is endothelial cell dysfunction and cellular death. With this cellular death, LDH leaks out with consequent raised serum LDH levels. Assessment of serum levels of LDH which is highly sensitive for any abnormality in the organ systems of the human body predicting maternal and fetal prognosis has always beendebatable.

Objectives: To compare serum LDH levels in normal pregnant women and in women with pre-eclampsia in late antepartum period and to study the correlation of maternal and perinatal outcomes with serum LDH levels.

Materials and methods: Total of 223 pre-eclamptic women (142 with mild pre-eclampsia and 81 with severe preeclampsia) and 223 controls were taken who satisfied the inclusion and exclusion criteria of the study. Demographic, hemodynamic and laboratory data were compared among the three groups. The symptoms and complications of severe pre-eclampsia along with the fetal outcome were analysed according to serum LDH levels.

Result: Age, gravidity and parity in women with severe pre-eclampsia shows statistically significant lower values (p<0.05). Increased systolic and diastolic blood pressure, urine albumin, serum uric acid, LDH, AST and ALT levels were seen in severe pre-eclampsia group, which was statistically significant (p<0.05). In severe pre-eclampsia group, symptoms, complications, maternal morbidity and perinatal mortality were significantly increased with increasing serum LDH levels (p<0.05). The correlation analysis with Spearman’s Rank correlation coefficient (rho ρ) was 0.701 which show highly positive correlation between maternal and perinatal outcomes with serum LDH levels.

Conclusion: Serum LDH is a reliable biochemical prognostic marker for severity of pre-eclampsia and its influence on the maternal and fetal outcome.