Serum Lactate Dehydrogenase as an Indicator of Maternal and Neonatal Outcomes in Hypertensive Disorders of Pregnancy

Abstract

Objective: To ascertain the sensitivity and specificity of serum lactate dehydrogenase as an indicator for maternal and neonatal outcomes in hypertensive disorders of pregnancy. Study Design: Cross-sectional, analytical study. Place and Duration of Study: Departments of Anesthesia and Gynecology & Obstetrics, Combined Military Hospital, Okara Cantt Pakistan, from Apr to Sep 2018. Methodology: Eighty-six pregnant women with pregnancy-induced hypertension were included in our study. Group-A included pregnant women with raised serum LDH, and Group-B included pregnant women with normal LDH levels. The patients were followed up until delivery and hospital discharge. Maternal and neonatal outcomes were studied. Results: The progression to hemolysis elevated liver enzyme low platelet (HELLP) syndrome was 4(4.8%) in Group-A versus zero in Group-B, p=0.022. The two groups did not vary in mode of delivery (cesarean section in 28 vs. 33); preterm delivery (22 versus 15); intrauterine growth retardation (8 vs. 6); intrauterine demise (9 vs 5); low APGAR at birth (13 vs. 7); eclampsia (3 vs. 3) which were comparable between the two groups, p-value>0.05. For overall maternal outcomes, the sensitivity for raised LDH was 57.1% and specificity 53.3%. The sensitivity was 51.2%, and the specificity was 54.7% for overall neonatal outcomes. Conclusion: Elevated serum LDH alone in pregnancy-induced hypertension cannot considered as a prognostic indicator for maternal and neonatal adverse outcomes, except HELLP syndrome

Keywords

• Eclampsia
• HELLP syndrome
• Lactate dehydrogenase
• Pre-eclampsia
• Preterm birth