A study on lactate dehydrogenase levels in hypertensive disorders of pregnancy and its correlation with feto-maternal outcome

Adarsh Preet; Ashok R. Anand

doi:10.18203/2320-1770.ijrcog20232293

Authors

Adarsh Preet Department of Obstetrics and Gynecology, Grant Government Medical College and JJ Group of Hospitals, Mumbai, Maharashtra, India
Ashok R. Anand Department of Obstetrics and Gynecology, Grant Government Medical College and JJ Group of Hospitals, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20232293

Keywords:

Hypertensive disorders, Lactate dehydrogenase levels, Maternal outcome

Abstract

Background: Hypertensive disorders of pregnancy are one of the most common medical disorders seen during pregnancy. Lactate dehydrogenase (LDH) is an intracellular enzyme. The objective of this study was to compare lactate dehydrogenase levels in women with hypertensive disorders of pregnancy and normal pregnant women, to correlate lactate dehydrogenase levels with complications of hypertensive disorders of pregnancy and role of lactate dehydrogenase as an early predictor of hypertensive disorders of pregnancy.

Methods: A study was conducted in the department of obstetrics and gynecology at JJ group of hospitals, Mumbai, India for a duration of 18 months from January 2020 to June 2021. This study has a sample size of 500 antenatal patients. Necessary information such as their detailed clinical, and obstetric history, clinical examination, investigations was noted. LDH were measured at 12-16 weeks of pregnancy and at the time of delivery.

Results: In our study, the incidence of hypertensive disorders of pregnancy was 10.2% There was no association between LDH levels at 12-16 weeks of gestation and development of hypertensive disorders of pregnancy. There was association between levels of lactate dehydrogenase levels at time of delivery and severity of hypertensive disorders in our study. Higher serum LDH levels were associated with increased incidence of maternal and fetal complications like abruption placenta, HELLP syndrome, IUGR, IUFD, prematurity and oligohydramnios in our study.

Conclusions: Hypertensive disorders of pregnancy are one of the medical conditions affecting pregnancy. Lactate dehydrogenase levels at 12-16 weeks of gestation is not early predictor of hypertensive disorders of pregnancy. Serum lactate dehydrogenase levels at time of delivery helps in prediction of severity of disease, adverse outcomes and complications of hypertensive disorders of pregnancy. Hence lactate dehydrogenase acts as prognostic factor in hypertensive disorders of pregnancy.

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References

Sibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2005;102(1):181-92.

Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066-74.

Nodler J, Moolamalla SR, Ledger EM, Nuwayhid BS, Mulla ZD. Elevated antiphospholipid antibody titers and adverse pregnancy outcomes: analysis of a population-based hospital dataset. BMC Pregnancy Childbirth. 2009;9(1):11.

Gynecology and Obstetrics preeclampsia. 2016. Available at: https://www.nhp.gov.in/disease/ gynaecology-andobstetrics/preeclampsia. Accessed on 1 March 2023.

Hypertensive Disorders. In: Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. eds. Williams Obstetrics, 25th edn. McGraw Hill; 2018.

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(8):393-7.

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.

WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia (PDF). 2011. Available at: https://www.who.int/publications/i/ item/9789241548335. Accessed on 1 March 2023.

Sengodan SS, Sreeprathi N. Prevalence of hypertensive disorders of pregnancy and its maternal outcome in a tertiary care hospital, Salem, Tamil Nadu, India. Int J Reprod Contracept Obstet Gynecol. 2020;9:236-9.

Jaiswar SP, Gupta Amrit, Sachan R, Natu SN, Mohan S. Lactic dehydrogenase: a biochemical marker for preeclampsia-eclampsia. J Obstet Gynecol India. 2011;61(6):645-8.

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. Med Sci Monit. 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. Gynecol Obstet Invest. 1995;39(4):234-8.

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