Assessment of Raised LDH Levels and Fetal Outcomes in Severe Preeclamptic Women: A Tertiary Care Hospital Study
Raised LDH Levels and Fetal Outcomes in Severe Preeclampsia
DOI:
https://doi.org/10.61919/jhrr.v4i3.1290Keywords:
Severe Pre-Eclampsia, Raised LDH Level, Still Birth, Perinatal OutcomeAbstract
Background: Preeclampsia is a dangerous complication of pregnancy characterized by high blood pressure and increased urinary protein, beginning typically after the 20th week of pregnancy. It ranges from mild to severe forms and is a significant cause of maternal and neonatal morbidity and mortality.
Objective: The study aimed to determine the frequency of raised Lactate Dehydrogenase (LDH) levels in women with severe preeclampsia visiting a tertiary care hospital and to evaluate the frequency of adverse fetal outcomes in these women with elevated LDH levels.
Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology at a Tertiary Care Hospital in Karachi over six months, from December 28, 2018, to June 29, 2019. The study included 121 pregnant women, aged 18 to 45 years, in their second trimester diagnosed with severe preeclampsia. A 5cc blood sample was collected from each participant to estimate LDH levels, with levels ≥200 IU/L considered raised. Adverse fetal outcomes were assessed at the time of delivery according to predefined operational definitions. Data were analyzed using SPSS version 25. Quantitative data were presented as mean ± SD, and qualitative data were presented as frequencies and percentages. The Chi-square test was applied for stratification, with a significance level set at 0.05.
Results: The mean age of the participants was 28.59 ± 4.91 years. Of the patients, 55.4% were aged ≤30 years, and 44.6% were aged >30 years. The mean gestational age was 32.73 ± 2.67 weeks, with 56.2% of patients having a gestational age >32 weeks. The mean LDH level was 430.66 ± 150.43 IU/L, with 97.5% of patients exhibiting raised LDH levels. Adverse fetal outcomes included stillbirths in 36.4% and perinatal deaths in 12.7% of patients with raised LDH levels.
Conclusion: A considerable number of patients with severe preeclampsia had raised LDH levels, which were significantly associated with adverse fetal outcomes, including stillbirth and perinatal death. Monitoring LDH levels in severe preeclamptic women is crucial for improving maternal and fetal outcomes.
Downloads
References
Dave A, Maru L, Jain A. LDH (Lactate Dehydrogenase): a biochemical marker for the prediction of adverse outcomes in pre-eclampsia and eclampsia. The Journal of Obstetrics and Gynecology of India. 2016;66:23-9.
Roberts J, Lain K. Recent insights into the pathogenesis of pre-eclampsia. Placenta. 2002;23(5):359-72.
Agrawal S, Walia G. Prevalence and risk factors for symptoms suggestive of pre-eclampsia in Indian women. J Women’s Health. 2014;3(6):2-9.
Morgan M, Thurnau G. Pregnancy-induced hypertension without proteinuria: is it true preeclampsia? Southern Medical Journal. 1988;81(2):210-3.
Barton JR, O’Brien JM, Bergauer NK, Jacques DL, Sibai BM. Mild gestational hypertension remote from term: progression and outcome. American journal of obstetrics and gynecology. 2001;184(5):979-83.
Duley L, editor The global impact of pre-eclampsia and eclampsia. Seminars in perinatology; 2009: Elsevier.
Yuan T, Wang W, Li X-L, Li C-F, Li C, Gou W-L, et al. Clinical characteristics of fetal and neonatal outcomes in twin pregnancy with preeclampsia in a retrospective case–control study: A STROBE-compliant article. Medicine. 2016;95(43).
Tesfahune E, Tadesse S, Bilchut A, Minda A, Ekubay M, Derseh B, et al. Prevalence of Preeclampsia and Associated Factors among Antenatal Care Attending Mothers at Tirunesh Beijing General Hospital, Addis Ababa, Ethiopia. Advances in Public Health. 2023;2023:1-5.
Sajith M, Nimbargi V, Modi A, Sumariya R, Pawar A. Incidence of pregnancy induced hypertension and prescription pattern of antihypertensive drugs in pregnancy. Int J Pharma Sci Res. 2014;23:4.
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, et al. Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5. The lancet. 2010;375(9726):1609-23.
Kuklina EV, Ayala C, Callaghan WM. Hypertensive disorders and severe obstetric morbidity in the United States. Obstetrics & Gynecology. 2009;113(6):1299-306.
Bartsch E, Medcalf KE, Park AL, Ray JG. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. BMJ (Clinical research ed). 2016;353:i1753.
Boyd P, Lindenbaum R, Redman C. Pre-eclampsia and trisomy 13: a possible association. The Lancet. 1987;330(8556):425-7.
Cincotta R, Brennecke S. Family history of pre‐eclampsia as a predictor for pre‐eclampsia in primigravidas. International Journal of Gynecology & Obstetrics. 1998;60(1):23-7.
Jain R, Upadhyay C, Mehta L, Nayak B, Desai G. Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia, Gujarat. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2017;6(8):3418-23.
Afroz R, Akhter QS, Sadia H, Sultana S. Serum Lactate Dehydrogenase (LDH) level in severe preeclampsia. Journal of Bangladesh Society of Physiologist. 2015;10(2):71-5.
Qublan HS, Ammarin V, Bataineh O, Al-Shraideh Z, Tahat Y, Awamleh I, et al. Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia. Medical science monitor: international medical journal of experimental and clinical research. 2005;11(8):CR393-7.
He S, Bremme K, Kallner A, Blombäck M. Increased concentrations of lactate dehydrogenase in pregnancy with preeclampsia: a predictor for the birth of small-for-gestational-age infants. Gynecologic and obstetric investigation. 1995;39(4):234-8.
Martin Jr JN, May WL, Magann EF, Terrone DA, Rinehart BK, Blake PG. Early risk assessment of severe preeclampsia: admission battery of symptoms and laboratory tests to predict likelihood of subsequent significant maternal morbidity. American journal of obstetrics and gynecology. 1999;180(6):1407-14.
Catanzarite VA, Steinberg SM, Mosley CA, Landers CF, Cousins LM, Schneider JM. Severe preeclampsia with fulminant and extreme elevation of aspartate aminotransferase and lactate dehydrogenase levels: high risk for maternal death. American journal of perinatology. 1995;12(05):310-3.
Demir SC, Evruke C, Ozgunen FT, Urunsak IF, Candan E, Kadayifci O. Factors that influence morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome. Saudi medical journal. 2006;27(7):1015.
Hall D, Odendaal H, Kirsten G, Smith J, Grove D. Expectant management of early onset, severe pre‐eclampsia: perinatal outcome. BJOG: An International Journal of Obstetrics & Gynaecology. 2000;107(10):1258-64.
Jaiswar S, Gupta A, Sachan R, Natu S, Shaili M. Lactic dehydrogenase: A biochemical marker for preeclampsia–eclampsia. The Journal of obstetrics and Gynecology of India. 2011;61:645-8.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Sanam Lashari, Taiba Khan, Sumaiya Yahaya, Dania Kumari, Zahid Hussain, Safia
This work is licensed under a Creative Commons Attribution 4.0 International License.
