Divya Lakshmi, A (2016) Lactic acid dehydrogenase and uric acid- biochemical markers for pre eclampsia - eclampsia. Masters thesis, Stanley Medical College, Chennai.
|
Text
Divya Lakshmi.pdf Download (7MB) | Preview |
Abstract
Hypertensive Disorders in pregnancy represents the most common medical complication of pregnancy which affects 7-15% of all gestations.WHO reports 16% of maternal deaths due to Hypertensive disease.Preeclampsia accounts for more than half of the cases.It is a disorder with course being progressive and continuous affecting virtually every organsystem.So it should be detected at an earlier stage so that appropriate management can be undertaken to prevent maternal and fetal morbidity and mortality.Preeclampsia is a multisystem disorder with lot of cellular death.LDH being an intracellular enzyme gets elevated in serum due to leakage of enzyme from inside the cells.Uric acid levels are raised in preeclampsia due to its reduced renal clearance.Hence this study was done to correlate serum LDH and uric acid levels with the severity of preeclampsia,Maternal and Fetal outcomes. MATERIALS AND METHODS: This study was a comparative observational study conducted among 165 Antenatal women in third trimester attending Antenatal OPD/Labour ward at Stanley Medical College during January to September 2015 after getting ethical clearance from the Institute Ethics Committee.Study group included 50 Normotensives,48 Mild preeeclamptics,53 Preeclamptics and 14 Eclamptics classified based on NHBPEP classification.Clinical History obtained as in structured proforma.After Informed consent from patients,blood samples were taken for Serum LDH,Uric acid estimation by IFCC and Uricase method respectively. Study group were divided into 3 subgroups based on LDH levels(<600IU/L, 600-800IU/L, >800IU/L) and based on uric acid levels(<6mg%, >6mg%). LDH and Uric acid values were compared with diagnostic components of preeclampsia such as Systolic BP,DiastolicBP,Proteinuria Gestational age at delivery,mode of delivery,birth weight of babies,maternal complications like Abruption,HELLP,Eclampsia,Pulmonaryedema,Intracranial Haemorrhage, Maternal death,Fetal complications like IUD, IUGR.The results were compared based on One Way Analysis of Variance,chi-square test and differences were considered as significant when p<0.05. OBSERVATION AND RESULTS: In our study,Extremes of age group(<19yrs,>30yrs) patients had increase severity of preeclampsia. Majority(55%) of patients were Primigravida.There was no association between parity and LDH,Uric acid levels.Among patients with LDH>800IU/L,98% patients had systolic BP>160mmHg.LDH level and systolic BP found to have significant association.Among patients with LDH 600-800IU/L and >800IU/L,60% and 96% respectively had Diastolic BP>110mmHg(P value< 0.001).Increasing LDH levels were associated with increasing severity of proteinuria(P<0.001).There was reduction in mean gestational age at delivery(<36 weeks) and mean birth weight of babies in groups with higher LDH levels propably due to more number of preterm deliveries in view of severity of preeclampsia.Groups with higher LDH levels(600-800 and >800IU/L) had more maternal and fetal complications(p<0.05).All those diagnostic variables were compared with uric acid levels.Group with uric acid >6mg% had significant association with Systolic BP,DiastolicBP,Proteinuria,Mean birth weight of babies,maternal and fetal morbidity and mortality. CONCLUSION: Serum LDH and uric acid values were significantly high in pre-eclamptic patients depending on the severity of the disease indicating the increased cellular turnover in them. Higher LDH and uric acid levels was associated with diagnostic components of preeclampsia. Hence diagnostic and management strategies may be considered based on S.LDH and uric acid levels and further studies on a larger sample can be done to substantiate our observations on the utility of this parameter as a diagnostic and prognostic component of preeclampsia. Development of new management strategies based on S. LDH and uric acid levels may help in appropriate decision making thereby avoiding unwanted maternal &fetal deaths.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | LDH; Uric Acid; Preeclampsia; Eclampsia |
| Subjects: | MEDICAL > Obstetrics and Gynaecology |
| Depositing User: | Punitha K |
| Date Deposited: | 28 Dec 2017 10:27 |
| Last Modified: | 28 Dec 2017 10:27 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/4933 |
Actions (login required)
 |
View Item |
