Lactate dehydrogenase as surrogate marker of preeclampsia and eclampsia

Authors

  • Muthuramalingam Vidhya Department of Obstetrics and Gynecology, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Madhuranthagam, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20201781

Keywords:

Antenatal women, Eclampsia, Hypertension, Maternal outcome, Serum lactate dehydrogenase

Abstract

Background: Hypertensive disorders of pregnancy is a spectrum of disorder which include chronic hypertension that antedates pregnancy and gestational hypertension or pre-eclampsia that is unique to human pregnancy. It is still a poorly understood condition. The clinical course is progressive and characterized by continuous deterioration that is arrested only by termination of pregnancy. Hence the disease must be detected in early stage and managed appropriately for improved maternal and fetal outcome.

Methods: The study consists of 173 antenatal patients of gestational age 28 weeks and above. Study population was divided into two groups, Group 1 consists of 50 antenatal women of normotensive nature served as controls and group 2 consists of 123 antenatal women with confirmed hypertension. Venous blood samples were collected used for the estimation of lactate dehydrogenase enzyme.

Results: Out of the total 173 patients 104 women delivered by C-section, 67 by normal vaginal delivery and 2 by assisted breech delivery. Among the women who delivered by caesarean 60 (57.69%) had serum LDH less than 600, 18 (17.30%) had serum LDH between 600 and 800 and 26 (25.00%) had LDH above 800. Among the women who delivered vaginally 61 (91.04%) had LDH less than 600, 1 (1.49%) had LDH between 600 and 800 and 5 (7.46%) had LDH above 800. Only 2 women delivered by assisted breech delivery one with LDH between 600 and 800 and another with S. LDH above 800.

Conclusions: The study was done in search of a valuable marker for preeclampsia and Eclampsia which would reflect the severity of the disease and would predict the maternal and fetal outcome. Such markers can help in decision making and can influence the current management protocols in order to achieve a better maternal and perinatal outcome.

 

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References

Belghiti J, Kayem G, Tsatsaris V, Goffinet F, Sibai BM, Haddad B. Benefits and risks of expectant management of severe preeclampsia at less than 26 weeks gestation: the impact of gestational age and severe fetal growth restriction. Am J Obstet Gynecol. 2011;205:465.e1-465.e6.

He S, Bremme K, Kallner A, Blombäck M. Increased concentrations of lactate dehydrogenase in pregnancy with preeclampsia; a predictor for birth of small for gestational age infants. Gynecol Obstet Invest. 1995;39:234-38.

Bombrys AE, Barton JR, Nowacki EA, Habli M, Pinder L, How H, et al. Expectant management of severe preeclampsia at less than 27 weeks’ gestation: maternal and perinatal outcomes according to gestational age by weeks at onset of expectant management. Am J Obstet Gynecol. 2008;199:247.e1-247.e6.

Qublan HS, Amarun V, Bateinen O. LDH as biochemical marker of adverse pregnancy outcome in severe preeclampsia. Med Sci Monit. 2005;11:393-7.

Levine RJ, Ewell MG, Hauth JC, Curet LB, Catalano PM, Morris CD, et al. Should the definition of preeclampsia include a rise in diastolic blood pressure of ≥ 15 mmHg to a level < 90 mm Hg in association with proteinuria?. Am J Obstet Gynecol. 2000;183(4):787-92.

Report on the National high blood pressure working group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22.

Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330(7491):565.

Fisher SJ, McMaster M, Roberts JM. The placenta in normal pregnancy and pre-eclampsia. In: Lindheimer MD, Roberts JM, Cunningham FG (eds). Chesley’s Hypertensive Disorders of Pregnancy, 3rd Edition. New York, Elsevier; 2009:73.

Caniggaia I, Winter J, Lye SJ, Post M. Oxygen and placenta development during the first trimester: implications for the pathophysiology of pre-eclampsia. Placenta. 2000;21 Suppl A:S25-30.

Madazil R, Budak E, Calay Z, Aksu MF. Correlation between placenta bed biopsy findings, vascular cell adhesion molecule and fibronection levels in pre-eclampsia. Br J Obstet Gynaecol. 2000;107:514.

Tanjung MT, Siddik HD, Hariman H, Koh SC. Coagulation and fibrinolysis in pre-eclampsia and neonates. Clin Appl Thromb Hemost. 2005;11(4):467-73.

Granger JP, Alexander BT, Llians MR, Bennett WA, Khalil RA. Pathophysiology of hypertension during pre-eclampsia linking placental ischemia with endothelial dysfunction. Hyper 2001;38(3 Pt 2):718-22.

Lindheimer WK, Genetic Factors in the Etiology of pre-eclampsia/ eclampsia. In: Lindheimer MD, Roberts JM, Cunningham FG (eds). Chesley’s Hypertensive Disorders in Pregnancy, 3rd edition. Elsevier; 2009:51.

Maynard SE, Min JY, Merchan J, Lim KH, Li J, Mondal S, et al. Excess placental soluable sms-like tyrosine kinase 1 9sFlt1) may contribute to endothelial dysfunction, hypertension and proteinuria in pre-eclampsia. J Clin Invest. 2003;111(5):649-58.

Levine RJ, Lam C, Qian C, Yu KF, Maynard SE, Sachs BP, et al. Soluble endoglin and other circulating antiangiogenic factors in pre-eclampsia. N Eng J Med. 2006;355:992-1005.

Gant NF, Chand S, Worley RJ, Whalley PJ, Crosby UD, MacDonald PC. A Clinical test useful for predicting the development of acute hypertension in pregnancy. Am J Obstet Gynecol. 1974;120(1):1-7.

Majumdar S, Dasgupta H, Bhattacharya K, Bhattacharya A. A study of placenta in normal and hypertensive pregnancies. J Anat Soc India. 2005;54(20):1-9.

Heilmann L, Rath W, Pollow K. Hemostatic abnormalities in patients with severe pre-eclampsia. Clin Appl Thromb Hemost. 2007;13(3):285-91.

Sibai BM. Diagnosis, prevention, and management of eclampsia. Obstet Gynecol. 2005;105(2):402-10.

Wagnar LK. Diagnosis and management of pre-eclampsia. Am Fam Physician. 2004;70(12):2317-24.

Grindheim G, Estensen ME, Langesaeter E, Rosseland LA, Toska K. Changes in blood pressure during healthy pregnancy; a longitudinal cohort study. J Hypertens. 2012;30(2):342-50.

Von Dadelszen P, Magee LA. Antihypertensive medications in management of gestational hypertension-pre-eclampsia. Clin Obstet Gynecol. 2005;48(2)441-59.

Chronic hypertension in pregnancy. Practice Bulletin No 125. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2012;119:396-407.

The Magpie Trial Collaborative group. Do women with pre-eclampsia and their babies benefit from magnesium sulphate? The magpie Trail: A randomized placebo-controlled trial. Lancer. 2002;359:1877-90.

Hofmeyer GJ, Lawrie TA, Atallah AN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014;24(6):CD001059.

Duley L, Henderson-Smart D, Meher S. Altered dietary salt for preventing pre eclampsia and its complications. Cochrane Database Syst Rev. 2005; 19(4):CD005548.

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

Bakhshandeh Nosrat S, Azarhoosh R, Borghei A, Sedaghat M, Besha Rat S, Ghalmi E. Serum of lactate dehydrogenase, homocystein, hemoglobin and platelet in preeclampsia. Pak J Med Sci. 2011;27(5):1014-7.

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Published

2020-04-28

How to Cite

Vidhya, M. (2020). Lactate dehydrogenase as surrogate marker of preeclampsia and eclampsia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 9(5), 1924–1929. https://doi.org/10.18203/2320-1770.ijrcog20201781

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Original Research Articles