A prospective study to assess role of serum lactate dehydrogenase in prediction of adverse outcomes of pre-eclampsia and eclampsia


  • Jyoti Jharia Department of Obstetrics and Gynaecology, MGM medical College and MY hospital, Indore, India
  • Pooja Mathur Department of Obstetrics and Gynaecology, MGM medical College and MY hospital, Indore, India
  • Anupama Dave Department of Obstetrics and Gynaecology, MGM medical College and MY hospital, Indore, India
  • Poonam Mathur Department of Obstetrics and Gynaecology, MGM medical College and MY hospital, Indore, India




Pre-eclampsia, Eclampsia, Serum LDH levels, Prediction, Outcome


Background: Pregnancy induced hypertension is one of the most dreaded complication in developing countries. The purpose of this study is to evaluate incidence, risk factors and complications of pre-eclampsia and eclampsia and its relation to serum LDH levels. This was done with a view to making recommendations towards furtherance of objectives of this initiative.

Methods: 380 patients with diagnosed eclampsia and preeclampsia were included based on a proforma.

Results: Higher grades of proteinuria, higher BP and serum LDH levels >600 IU/L are significantly associated with adverse maternal and fetal outcome.

Conclusions: LDH co-relates with adversity of maternal and fetal outcome in eclampsia and pre-eclampsia.


Gabbe. Obstetrics: Normal and Problem Pregnancies. In: Hypertension. 5th ed. Churchill Livingstone, An Imprint of Elsevier; 2007.

Mattar F, Sibai BM. Eclampsia VIII risk factors for maternal morbidity. Am J Obstet Gynecol. 1990;163:1049-55.

Douglas KA, Redman CW. Eclampsia in the United Kingdom. British Med J. 1994;309(6966):1395-400.

Mabel L, Purkerson L, Verkerdi. History of Eclampsia, toxemia and Kidney in pregnancy. Am J Nephrol. 1999;19:313-19.

Craici I, Wagner S, Garovic VD. Preeclampsia and future cardiovascular risk: formal risk factor or failed stress test?. Ther Adv Cardiovasc Dis. 2008;2(4):249-59.

Banerjee S, Randeva H, Chambers AE. Mouse models for preeclampsia: disruption of redox-regulated signaling. Reprod Biol Endocrinol. 2009;7:4.

Cadden KA, Walsh SW. Neutrophils, but not lymphocytes or monocytes, infiltrate maternal systemic vasculature in women with preeclampsia. Hypertens Pregnancy. 2008;27(4):396-405.

Kay HH, Zhu S, Tsoi S. Hypoxia and lactate production in trophoblast cells. Placenta. 2007;28:854-60.

Baweja S, Kent A, Masterson R, Roberts S, McMahon L. Prediction of pre-eclampsia in early pregnancy by estimating the spot urinary albumin: creatinine ratio using high-performance liquid chromatography. British J Obst Gynae. 2011;118(9):1126-32.

Boudava F, Cheli D. Eclampsia-epidemiological aspects and management of 28 patients. Tunis Med. 2008;86(7):685-8.

Tsoi SCM, Zheng J, Xu F, Kay HH. Differential expression of lactate dehydrogenase isozymes (LDH) in human placenta with high expression of LDH-A4 isozyme in the endothelial cells of pre-eclampsia villi. Placenta. 2001;22:317-22.

Bougneres PF, Rocchiccioli F, Nurjhan N, Zeller J. Stable isotope determination of plasma lactate conversion into glucose in fasting infants. Am J Physiol. 1995;268:652-9.

Burd LI, Simmons MA, Makowski EL, Meschia G, Battaglia FC. Placental production and foetal utilization of lactate and pyruvate. Nature. 1975;254:710-1.

Semenza GL, Roth PH, Fang HM, Wang GL. Transcriptional regulation of genes encoding glycolytic enzymes by hypoxia-inducible factor. J Biol Chem. 1994;269:23757-63.

Magee LA, Helewa M, Moutquin JM, Dadelszen P. Hypertension guideline committee, society of obstetricians and gynaecologists of Canada. prediction, prevention, and prognosis of preeclampsia. J Obstet Gynaecol Can. 2008;30(3):16-23.

Demir SC, Evruke C, Ozgunen FT. Factors that influences morbidity and mortality in severe pre-eclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome. Saudi Med J. 2006;27(7):1015-8.

Rivers EP. The clinical practice of emergency medicine. In: Preeclampsia, eclampsia, and other hypertensive disorders of pregnancy. 2nd edition. Lippincott Williams and Wilkins; 1996:315-21.

Sibai BM. Eclampsia VI maternal and perinatal outcome. Am J obstet. Gynecol. 1990;163(3):1049-54.

Sibai BM, Sarinoglu C, Mercer BM. Eclampsia VII pregnancy outcome after eclampsia and long-term prognosis. Am J Obstet Gynecol. 1992;166(6):1757-61.

Mackay AP, Berg CJ, Atrash HK. Pregnancy-related mortality from preeclampsia and eclampsia. Obstet Gynecol. 2001;97(4):533-8.

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;9:11.

Vigil P. Maternal deaths due to eclampsia and HELLP syndrome. Int J Gynaecol Obstet. 2009;104(2):90-4.

Swain S, Ojha KN, Prakash A, Bhatia BD. Maternal and perinatal mortality due to eclampsia. Indian Pediatr. 1993;30(6):771-3.

Choudhary P. Eclampsia: a hospital based retrospective study. Kathmandu Univ Med J. 2003;1(4):237-41.

Bhagwanjee S, Paruke, Moodley J, Muckart DJ. Intensive care unit morbidity and motality from eclampsia. an evaluation of acute physiology and chronic health evaluation ii score and the glasgow coma scale score care. Crit Care Med. 2000;28(1):120-4.

Rinehart BK, Terrone DA, May WL, Magann EF, Isler CM, Martin JN. Change in platelet count predicts eventual maternal outcome with syndrome of hemolysis, elevated liver enzymes and low platelet count. J Matern Fetal Med. 2001;10(1):28-34.

JP Adam, Sayeba A. Perinatal outcome of eclampsia in Dhnka medical college hospital. Bangladesh J Obstet Gynaecol. 2008;23(1):20-4.

Qublan HS, Ammarin V, Bataineh O. Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia. Med Sci Monit. 2005;11(8):393-7.

Qublan HS, Ammarin V, Bataineh O, 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):393-7.

Wasim T, Siddiqui S, Gulli M. Eclampsia a major cause of maternal and perinatal mobidity and mortality, the professional. Ethiop J Health Sci. 2015;25(2):111-6.

Aali BS, Ghafoorian J, Alizadeh SM. Severe pre-eclampsia and eclampsia in Kerman, Iran, complications and outcomes. Med Sci Monit. 2004;10(4):163-7.

Markert CL, Shaklee JB, Whitt GS. Evolution of a gene: multiple genes for LDH isozymes provide a model of the evolution of gene structure, function and regulation. Science. 1975;189:102-14.






Original Research Articles