Title: The Role of serum, Lactate Dehydrogenase and other Biochemical parameters in assessing the severity preeclampsia
Abstract: INTRODUCTION:
Preeclampsia and eclampsia complicate 6-8% of all pregnancies and lead to various maternal and fetal complications. Serum LDH levels can be used to assess the extent of cellular death and thereby the severity of disease in this group of women. This can be further used as help in making decision, regarding the management strategies to improve the maternal and fetal outcome.
AIM AND OBJECTIVES:
To correlate the severity of disease, maternal and perinatal outcomes with serum LDH level and other biochemical parameters like Hb, platelets, S. urea, Serum creatinine, total bilirubin, AST,ALT, Serum Uric acid in patients with preeclampsia.
METHODS:
This was a prospective comparative study conducted in the department of Obstetrics and Gynecology in Govt. Rajaji Hospital, Madurai from Sep 2015 to Aug 2016. Pregnant women were enrolled in this study in the third trimester of pregnancy and divided into following groups:
• Group 1—healthy normal pregnant women (controls) • Group-2—patients of preeclampsia and eclampsia (subjects). This was further subdivided into following subgroups
• Non severe preeclampsia.
• Severe preeclampsia. • Eclampsia Subjects were also divided according to the serum LDH levels into following groups:- • 800 IU/1.
All women were followed until delivery and early postpartum period and babies till early neonatal period.
RESULTS.
• 66.96% of control, 22.31% of NSP, 9.82% of SP and 0.89% of eclampsia had LDH < 600 IU/L.
• 70.51% of SP, 17.64% NSP and 11.46% eclampsia had LDH 600-800 IU/L.
• 80.95% cases of eclampsia and 19.04% cases of SP had LDH >800 IU/L.
LDH AND MATERNAL COMPLICATIONS • Maternal complications were more in LDH> 800IU/L.
Among the complications, HELLP in 23.80% cases, PRES in 28.57%, MODS in 14.28% cases, Retinopathy in 9.52% cases, AKI in 4.76% case, DIC in 9.52% cases were present when LDH> 800IU/L Abruption with DIC present in 11.76% patients, HELLP Syndrome 11.76% of patients, MODS in 5.88% cases, Macular edema in 5.88% cases and mild PHT in 5.88% cases were present when LDH 600-800IU/L.
Retinopathy contributing to 0.89% present when LDH <600IU/L
LDH AND PERINATAL OUTCOME:
• LDH >800IU/L • Totally 21 babies were born to mother with LDH >800 of which 5 babies (23.80%) were IUD, 12 babies (57.14%) expired and only 4 babies (19.04%) were healthy babies. • 95% babies had birth weight 2.5kg LDH 600-800IU/L Among 17 babies born to mother with LDH 600-800 IU/L, 13 babies (76.47%) were healthy babies, 3 babies (17.64%) expired and 1 was IUD 80% babies had birth weight 2.5 kg LDH 2.5kg.
OTHER PARAMETERS: Also there was statistically significant association between other parameters like Hb, platelet, AST, ALT, S.Urea, S.Creatinine, S.Uric acid in assessing the severity of preeclampsia except S.bilirubin which was statistically insignificant.
CONCLUSION:
Thus serum LDH is the earliest marker in blood in conditions associated with hypoxia & oxidative stress. Thereby it is raised in Preeclampsia & Eclampsia. It predicts the severity & occurrence of complications in Preeclampsia & Eclampsia. The complications can be prevented if it is measured earlier, if adequately managed at a higher center. Hence we conclude that screening with LDH is essential for all cases of preeclampsia and eclampsia for early detection and management of complications.
Publication Year: 2017
Publication Date: 2017-04-01
Language: en
Type: dissertation
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