Menisri, N (2019) Correlation of Elevated Serum LDH Levels with Adverse Maternal and Perinatal Outcome in Preeclampsia. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
AIM OF THE STUDY: To study the correlation between the elevated serum lactate dehydrogenase level with the severity of disease and maternal and perinatal outcome in pre-eclampsia. OBJECTIVES: 1. Correlation of the levels of serum lactate dehydogenase with severity and maternal and fetal complications of pre-eclampsia. 2. Role of serum lactate dehydrogenase as a biochemical marker in pre-eclampsia so as to decrease maternal morbidity and mortality. SOURCE OF STUDY: Study group consists of preeclamptic pregnant women who is admitted in Coimbatore Medical College Hospital in the department of Obstetrics and Gynaecology. Design of Study: Prospective study. PERIOD OF STUDY: May 2017-April 2018. Sample Size: 200. Inclusion Criteria: Primi / Multigravida, Antenatal women with pre-eclampsia, more than 20 weeks of gestation, 18- 35 years of age with singleton pregnancy. Exclusion Criteria: Antenatal mothers with hypertension at/ before20 weeks of gestation. Patients with history of liver disease ,hemolytic disease, diabetes mellitus, multiple pregnancy, renal disease, stroke, connective tissue disorders, thyroid disorder, epilepsy, smoking alcohol behaviour and those on hepatotoxic drugs. Preeclampsia which is a multisystem disorder in pregnancy, leading to maternal as well as perinatal morbidity and mortality. In preeclampsia, there is systemwide endothelial dysfunction and vasospasm and the resulting cellular damage due to hypoxia causes multiorgan damage. Serum lactate dehydrogenase which is an intracellular enzyme which converts pyruvic acid into lactate in anerobic conditions. serum LDH level can be used as a marker to assess the severity of disease and also to predict the occurrence of complications of preeclampsia like eclampsia, HELLP syndrome, acute renal failure, acute pulmonary edema, abruptio placenta, and cortical vein thrombosis. In this study, 200 antenatal women with preeclampsia were included and serum LDH was done. Based on the serum LDH levels, patients were divided into three groups and followed until delivery and early postpartum period. 25% (50) of patients in the study had LDH levels in the range of 300- 600 IU/l, 39% in the range of 600-800 IU/l and 36% of patients had LDH values more than 800 IU/l. In our study, among the patients with serum LDH levels in the range of 300- 600 IU/l (50 patients), 24% (12) had eclampsia and 2% (1) had aruption and none of the patients had complications like HELLP syndrome, acute renal failure, pulmonary edema and cortical vein thrombosis. whereas in those with serum LDH levels in the range of 600- 800 IU/L (78 patients), 32% (25 patients) had eclampsia, 8.9% ((9) had cortical vein thrombosis, 14% (11) had abruption placenta, 23% (18) had HELLP syndrome and none of the patient had other complications like acute renal failure and pulmonary edema. Among those with serum LDH levels more than 800 IU/l(72), 15% (11) had eclampsia, 25% (18) had cortical vein tghrombosis,23% had abruption placenta, 9.7% (7) had acute renal failure, 8% (11) had pulmonary edema and 11% (8) had HELLP syndrome. There is increase in incidence of perinatal death and fetal growth restriction and iatrogenic preterm babies with increase in levels of serum LDH. Thus serum Lactate dehydrogenase can be used as a biochemical marker to assess the severity of the disease and to predict the complications in all preeclampsia patients and the early intervention and management can prevent complications and thereby helps to improve the maternal and perinatal outcome in preeclampsia patients.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Reg. No.221616304 |
| Uncontrolled Keywords: | Elevated Serum LDH Levels, Adverse Maternal and Perinatal Outcome, Preeclampsia. |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Subramani R |
| Date Deposited: | 28 Aug 2019 16:12 |
| Last Modified: | 28 Aug 2019 16:12 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/11303 |
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