Assessment of Raised LDH Levels and Fetal Outcomes in Severe Preeclamptic Women: A Tertiary Care Hospital Study

Background: Preeclampsia is a dangerous complication of pregnancy characterized by high blood pressure and increased urinary protein, beginning typically after the 20th week of pregnancy. It ranges from mild to severe forms and is a significant cause of maternal and neonatal morbidity and mortality. Objective: The study aimed to determine the frequency of raised Lactate Dehydrogenase (LDH) levels in women with severe preeclampsia visiting a tertiary care hospital and to evaluate the frequency of adverse fetal outcomes in these women with elevated LDH levels. Methods: This descriptive cross-sectional study was conducted in the Department of Obstetrics and Gynecology at a Tertiary Care Hospital in Karachi over six months, from December 28, 2018, to June 29, 2019. The study included 121 pregnant women, aged 18 to 45 years, in their second trimester diagnosed with severe preeclampsia. A 5cc blood sample was collected from each participant to estimate LDH levels, with levels ≥200 IU/L considered raised. Adverse fetal outcomes were assessed at the time of delivery according to predefined operational definitions. Data were analyzed using SPSS version 25. Quantitative data were presented as mean ± SD, and qualitative data were presented as frequencies and percentages. The Chi-square test was applied for stratification, with a significance level set at 0.05. Results: The mean age of the participants was 28.59 ± 4.91 years. Of the patients, 55.4% were aged ≤30 years, and 44.6% were aged >30 years. The mean gestational age was 32.73 ± 2.67 weeks, with 56.2% of patients having a gestational age >32 weeks. The mean LDH level was 430.66 ± 150.43 IU/L, with 97.5% of patients exhibiting raised LDH levels. Adverse fetal outcomes included stillbirths in 36.4% and perinatal deaths in 12.7% of patients with raised LDH levels. Conclusion: A considerable number of patients with severe preeclampsia had raised LDH levels, which were significantly associated with adverse fetal outcomes, including stillbirth and perinatal death. Monitoring LDH levels in severe preeclamptic women is crucial for improving maternal and fetal outcomes.