Title: Role of Lactate Dehydrogenase (LDH) as a Earliest Biochemical Marker for the Prediction of Adverse Outcomes in Pre-Eclampsia and Eclampsia in Tertiary Care hospital at S.K.M.C.H. Muzaffarpur, Bihar
Authors: Dr Anant Prasad, Dr Anita Suneel
DOI: https://dx.doi.org/10.18535/jmscr/v7i10.142
Abstract
Objective: Lactate dehydrogenase is present in all cells of the body but its higher concentrations are found in liver, heart, kidney, skeletal muscle and erythrocytes. Total LDH concentration in serum or plasma is increased in patients with liver disease, renal disease, myocardial infarction, many malignant diseases, progressive muscular dystrophy and almost any cause of hemolysis. On the findings of a single test result clinical diagnosis should not be done, but should integrate both clinical and laboratory tests finding. Aim of present study was to evaluate the role of Serum lactate dehydrogenase as a prediction of adverse feto-maternal outcomes like severity of disease and occurrence of complications in cases of pre-eclampsia and eclampsia.
Materials and Methods: A total of 81 pregnant women (healthy woman as a control n=27, pre-eclamptic n=27 and eclamptic n=27) with age group ranges from 18 to 35 years attending in the Gynecological OPD and IPD with different Pregnancy induced hypertension (PIH) complains were included in the study. After thorough clinical history, all the patients were subjected to proper clinical examination and referred to our department for LDH estimation. LDH estimation was done by IFCC methods on Biosystem. Depending on the values obtained, the cases were divided into three groups. Group A- Levels of LDH <600U/L, Group B- Levels between 600 U/L to 800 U/L, Group C -Levels >800 U/L.
Results: Group A: LDH level <600 U/L had 11.11 % of pre-eclamptic cases and 25.92 % of eclamptic cases and 88.88 % of normal cases. Group B: LDH level 600-800 IU/L had 22.22 % of pre-eclamptic and 81.48 % of eclamptic cases. Group C: LDH level >800 U/L had 37.03 % of pre-eclamptic and 66.66 % of eclamptic cases.
Conclusion: LDH is the earliest biochemical marker seen in blood during hypoxia and oxidative stress. It is a useful biochemical marker for severity and occurrence of complications of pre-eclampsia and eclampsia, these are preventable if identified at an earlier stage and adequately managed at tertiary care center. So that screening of all cases of Preeclampsia and Eclampsia with LDH levels should be made mandatory.
Keywords: Lactate dehydrogenase (LDH), Preeclampsia and Eclampsia, Pregnancy induced hypertension (PIH), NADH, Biochemical marker.
References
- Lorentz K, Klauke R, Schimidt E. Recommendation for the determination of the catalytic concentration of lactate dehydrogenase at 37 °C. Eur J Clin Chem Clin Biochem 1993;31:897-899.
- van der Heiden C, Bais R, Gerhardt W, Lorentz K, Rosalki S. Approved recommendation on IFCC methods for the measurement of catalytic concentration of enzymes. Part 8 IFCC method for lactate dehydrogenase. Eur J Clin Chem Clin Biochem 1994;32:639-655.
- Young DS. Effects of drugs on clinical laboratory tests, 4th ed. AACC Press, 1995.
- Tietz Textbook of Clinical Chemistry, 2nd edition. Burtis CA, Ashwood ER. WB Saunders Co., 1994.
- Friedman and Young. Effects of disease on clinical laboratory tests, 3th ed. AACC Press, 1997.
- Cunningham FC, Leveno KJ, Bloom SL, et al.Williams obstetrics. 23. New York: McGraw-Hill; 2010. p. 706.
- All BS, Ghafoorian J, Alizadeh Sm. Severe pre-eclampsia and eclampsia in Kerman, Iran, complications and outcomes. Med Sci Monit. 2004;10(4):CR163-7. 8. Qublan HS, Ammarin V, Bataineh. Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe pre-eclampsia. Med Sci Monit. 2005;11(8):CR393-CR397.