RESUMO
Hypertensive disorders are one of the leading causes of maternal mortality. Lactate dehydrogenase (LDH) is one of the markers to study the severity of pre-eclampsia. It is an intracellular enzyme which increases in pre-eclampsia due to cellular lysis. We wanted to assess the LDH levels in normal pregnant women and women with pre-eclampsia in antenatal period and study the role of LDH as a biochemical marker to predict adverse outcomes in pre-eclampsia. METHODSThis is a prospective observational study conducted between October 2016 and August 2018 at Sri Ramachandra Institute of Higher Education and Research. Antenatal women > 28 weeks were grouped as healthy normotensive women and those with pre-eclampsia and eclampsia. Antenatal women < 28 weeks, with pre-existing diabetes mellitus, renal disease, liver disease and epilepsy were excluded from the study. LDH levels were assessed. Both groups were followed up closely for new or worsening signs and symptoms of pre-eclampsia, till delivery and early postpartum period. LDH levels in both groups were broadly divided into 3 groups (< 600 IU / L, 600 - 800 IU / L, > 800 IU / L). Maternal and perinatal outcomes were studied in these groups. RESULTSAll normotensive antenatal women and 128 out of 147 (87 %) hypertensive antenatal women had a normal LDH value (< 600 IU / L). While the babies of 58.6 % of hypertensive antenatal women with normal LDH required NICU admission, babies of 68.4 % of those with elevated LDH required NICU admission (p value > 0.05). Hence, levels of LDH do not correlate with the severity of pre-eclampsia and neonatal outcome. Also, 47.4 % of hypertensive antenatal women with elevated LDH had HELLP syndrome; 10.5 % had disseminated intravascular coagulation and 63.2 % required ICU admission. P value was < 0.05. Therefore, increasing LDH level had a positive correlation with maternal complications like HELLP syndrome, disseminated intravascular coagulation and the need for ICU admission. CONCLUSIONSOur study showed no correlation between lactate dehydrogenase and the incidence of pre-eclampsia. LDH is a good biochemical marker to predict adverse maternal outcomes of pre-eclampsia but not neonatal outcome.