Role of IDH as a prognostic marker in preeclampsia/eclampsia: a comparative case control study

Zeenat U Nisa; Rubia Bano; Syed Uzma; Syed Ishfa; Syed Mubashir

doi:10.18203/2320-1770.ijrcog20230814

Authors

Zeenat U Nisa Department of Obstetrics and Gynecology, Government Medical College, Srinagar, Jammu and Kashmir, India
Rubia Bano Department of Obstetrics and Gynecology, SKIMS MCH, Srinagar, Jammu and Kashmir, India
Syed Uzma Department of Obstetrics and Gynecology, SKIMS MCH, Srinagar, Jammu and Kashmir, India
Syed Ishfa Department of Biochemistry, University of Kashmir, Jammu and Kashmir, India
Syed Mubashir Department of Obstetrics and Gynecology, Government Medical College, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20230814

Keywords:

PIH, Pregnancy

Abstract

Background: Preeclampsia is a multisystem disorder which complicates 5-8% of all pregnancies. LDH is an intracellular enzyme and its level is increased in these women due to cellular death. Serum LDH levels can be used to assess the extent of cellular death and thereby the severity of disease in this group of women.

Methods: It was a prospective case control study. Data was analysed using SPSS 16.0. The sample comprised of approximately 154 cases. All patients were of gestational age 28 weeks and above. They were divided into three groups 45 normotensives, 40 mild pre-eclamptics, 41 severe pre-eclamptics and 28 eclamptics.

Results: Serum LDH levels consistently increased with increasing systolic and diastolic blood pressure, more so with diastolic blood pressure with a p value of <0.001. Most of the women with severe preeclampsia and eclampsia had severe proteinuria and serum LDH significantly increased with the severity of proteinuria (p<0.00). The incidence of operative delivery was moderately elevated with increased LDH level. The mean gestational age at the time of delivery in patients with serum LDH less than 600, 600 to 800 and more than 800 are 37.94 35.36 and 33.87 weeks. The mean baby weight in patients with serum LDH less than 600, 600 to 800 and more than 800 was 2.80, 2.62 and 1.81 kg.

Conclusions: Serum LDH values were significantly high in pre-eclamptic patients depending on the severity of the disease. Serum LDH levels had a good correlation with all the diagnostic components of preeclampsia like SBP, DBP and proteinuria, similarly with maternal and fetal morbidity and mortality.

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References

Lain KY, Roberts JM. Contemporary concepts of the pathogenesis and management of preeclampsia. JAMA. 2002;287(24):3183-6.

Qublan HS, Amarun V, Bateinen O, Al-Shraideh Z, Tahat Y, Awamleh I, et al. LDH as biochemical marker of adverse pregnancy outcome in severe preeclampsia. Med Sci Monit. 2005;11:393-7.

Jaiswar SP, Gupta A, Sachan R, Natu SN, Shaili M. Lactic-dehydrogenase: a biochemical marker for preeclampsia-eclampsia. JOGI. 2011;61(6):645-8.

Qublan HS, Amarun V, Bateinen O, Al-Shraideh Z, Tahat Y, Awamleh I, et al. LDH as biochemical marker of adverse pregnancy outcome in severe preeclampsia. Med Sci Monit. 2005;11:393-7.

Trends in maternal mortality: 1990 to 2010. WHO, UNICEF, UNFPA and the World Bank estimates. Available from: http://whqlibdoc.who.int/ publications/2012/9789241503631_eng.pdf. Accessed on 12 July 2012.

Butt AA, Michaels S, Greer D, Clark R, Kissinger P, Martin DH. Serum lactate [8] dehydrogenase level as a clue to the diagnosis of histoplasmosis. AIDS Read. 2002;12(7):317-21.

Malik KK, Akmal N, Akhter N. Correlation of lactate dehydrogenase levels with the severity of pre-eclampsia. Tohoku J Exp Med. 2004;202:87-92.

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health Volume 3, Issue 2, Pages 58-59, April 2013.

Kamath R, Nayak R, Shantharam M. Serum uric acid level in preeclampsia and its correlation to maternal and fetal outcome. Int J Biomed Res. 2014;5(1):22.

Lu H, Forbes RA, Verma A. Hypoxia-inducible factor 1 activation by aerobic glycolysis implicates the Warburg effect in carcinogenesis. J Biol Chem. 2002;277(26):23111-5.

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 Med J. 2006;27(7):1015.

Bougnères PF, Rocchiccioli F, Nurjhan N, Zeller J. Stable isotope determination of plasma lactate conversion into glucose in fasting infants. Am J Physiol. 1995;268:E652-9.

Munde SM, Hazari NR, Thorat AP, Gaikwad SB, Hatolkar VS. Gamma glutamyl transferase and lactate dehydrogenase as biochemical markers of severity of preeclampsia. Int J Med Health Pharm Biomed Eng. 2014;8:50-3.

Jaiswar SP, Gupta A, Sachan R, Natu SN, Shaili M. Lactic-dehydrogenase: a biochemical marker for preeclampsia-eclampsia. JOGI. 2011;61(6):645-8.

15. Vidhya, Muthuramalingam. "Lactate dehydrogenase as surrogate marker of preeclampsia and eclampsia." International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 9, no. 5, May 2020, pp. 1924s.

Jaiswar SP, Gupta A, Sachan R, Natu SN, Shaili M. Lactic-dehydrogenase: a biochemical marker for preeclampsia-eclampsia. JOGI. 2011;61(6):645-8.

Hak J, Gupta S. LDH levels in pregnancy and its association with severity of the disease and feto-maternal outcome in pre-eclampsia and eclampsia. JK Sci. 2015;17(3):110.