Correlation of Biochemical Markers of Serum Uric Acid and Lactate Dehydrogenase in Preeclampsia With Feto-Maternal Outcomes

Abstract

Introduction: Hypertensive disorders complicate 5-10% of all pregnancies worldwide. There are controversies aboutthe association between serum biomarkers and the severity of disease in the literature. AIM: To evaluate serum biomarkers uric acid(UA) and lactate dehydrogenase(LDH) in preeclamptic women and their prognostic role in maternal and fetal outcomes. Materials And Methods: Prospective study. A total of 52 women with preeclampsia were subjected to UA and LDH estimation and followed up in the obstetrics and gynecology department, NRIGH, Chinakakani, Andhra Pradesh from July 2019 to December 2019. Results: Out of 52 cases, 31(59.5%) and 21(40.2%) had non-severe and severe preeclampsia. 13 women had elevated LDH and 25 had elevated UA, out of which 7(13.4%) had both. Complications observed were more in women with LDH > 600U/L and serum UA ≥6mg%.Out of 7 patients with eclampsia, both were elevated in 3, isolated elevation of LDH in 2 cases. 6 had PRES; only 1 had an elevation of both, isolated elevation of UA and LDH in 2 each. Out of 4 patients with thrombocytopenia, 3 had an elevation of both and 1 had an elevation of UA. Only 1 of 52 cases had retinal detachment with the elevation of both markers. 4 out of 8 ICU admission had both markers elevated. All 3 patients who developed pulmonary edema had elevated UA, and only 1 had elevated LDH. Fetal morbidity like preterm delivery, LBW, IUGR, NICU admission were more in elevated UA while IUFD was more in elevated LDH women. Conclusion: As ours is a small study group, we cannot conclude which biomarker is better, but both UA and LDH may be reliable in preeclampsia and its prognosis as per our study findings. CLINICAL SIGNIFICANCE: Monitoring serum UA and LDH levels during antenatal period may help in early intervention and help prevent maternal and fetal morbidity and mortality due to preeclampsia.