Dave Anupama, Maru Laxmi, Jain Astha
Department of Obstetrics and Gynaecology, M. Y. Hospital & MGM Medical College, 314, Saket Nagar, Indore, 452018 Madhya Pradesh India.
J Obstet Gynaecol India. 2016 Feb;66(1):23-9. doi: 10.1007/s13224-014-0645-x. Epub 2014 Dec 2.
The aim of the study was to find out the role of Serum lactate dehydrogenase in prediction of adverse outcomes of PE & E i.e., severity of disease and occurrence of complications.
This study was conducted in the Department of Obstetrics and Gynaecology, MGM Medical College, Indore. A total of 200 women were studied; they were divided into control (n = 100), severe pre-eclampsia (n = 32), eclampsia (n = 68). Demographic and hematological parameters were studied including LDH levels.
The incidence of severe pre-eclampsia-1.2 % & Eclampsia 2.7 %, PE & E patients were significantly younger, with low gravidity and parity. They had significantly increased systolic and diastolic pressure, liver enzymes, uric acid, urine albumin, and LDH levels. Serum urea and creatinine were normal in majority of cases. The symptoms and complications of PE along with perinatal mortality were increased significantly in patients with LDH >800 IU/l compared with those who had lower levels. Complications like Retinopathy, ARF, Abruptio, DIC, CVA, MODS, Shock were also associated with high level of serum LDH >800 IU/L. Low birth weight of babies was also associated with high level of serum LDH levels in PE & E patients. The incidence of poor perinatal outcome was higher in PE & E patients with high serum LDH level (>600 IU/L).
LDH is the earliest marker seen in blood during hypoxia and oxidative stress. It is a useful biochemical marker that reflects the severity of and the occurrence of complications of PE & E; these are preventable if identified at an earlier stage and adequately managed at a higher center. Test is easily available, so screening of all cases of PE & E with LDH levels must be made mandatory.
本研究旨在探讨血清乳酸脱氢酶在预测子痫前期和子痫不良结局（即疾病严重程度和并发症发生率）中的作用。
本研究在印多尔市MGM医学院妇产科进行。共研究了200名女性，分为对照组（n = 100）、重度子痫前期组（n = 32）、子痫组（n = 68）。研究了人口统计学和血液学参数，包括乳酸脱氢酶水平。
重度子痫前期的发生率为1.2%，子痫为2.7%，子痫前期和子痫患者明显更年轻，妊娠次数和产次较低。他们的收缩压和舒张压、肝酶、尿酸、尿白蛋白和乳酸脱氢酶水平显著升高。大多数病例的血清尿素和肌酐正常。与乳酸脱氢酶水平较低的患者相比，乳酸脱氢酶>800 IU/l的患者子痫前期的症状和并发症以及围产期死亡率显著增加。视网膜病变、急性肾衰竭、胎盘早剥、弥散性血管内凝血、脑血管意外、多器官功能障碍综合征、休克等并发症也与血清乳酸脱氢酶>800 IU/L的高水平相关。子痫前期和子痫患者中，婴儿低出生体重也与血清乳酸脱氢酶高水平相关。血清乳酸脱氢酶水平高（>600 IU/L）的子痫前期和子痫患者围产期不良结局的发生率更高。
乳酸脱氢酶是缺氧和氧化应激时血液中最早出现的标志物。它是一种有用的生化标志物，可反映子痫前期和子痫的严重程度及并发症的发生情况；如果在早期发现并在上级中心进行适当管理，这些情况是可以预防的。该检测易于获得，因此必须强制对所有子痫前期和子痫病例进行乳酸脱氢酶水平筛查。
