scholarly journals Maternal serum lactate dehydrogenase level and adverse pregnancy outcomes in women with hypertensive disorder of pregnancy at a tertiary care centre: a retrospective study

2021 ◽  
Author(s):  
Disha Ajila ◽  
Aishwarya Raja ◽  
Pradeep Ganiga
Keyword(s):  
Retrospective Study ◽  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Research Centre ◽  
Serum Lactate Dehydrogenase ◽  
Hypertensive Disorder ◽  
Apgar Scores ◽  
Hypertensive Disorder Of Pregnancy

Background: Hypertensive disorder of pregnancy affect 6-8% of all pregnancies, contributing immensely to maternal morbidity and mortality. Thus, presence of lactate dehydrogenase (LDH) signifies tissue damage and haemolysis. The aim of the study was to correlate LDH levels with blood pressure ranges and maternal and foetal outcome in women with gestational hypertension, pre-eclampsia.Methods: This retrospective study was conducted in the department of obstetrics and gynaecology of AJ Institute of Medical Sciences and Research Centre, Mangalore for a period of 1 year (January 2020 to January 2021). Based on the eligibility criteria, 52 hypertensive pregnant women were enrolled as cases.Results: Mean±SD period of gestation at delivery was lowest (34.57±1.39 weeks) for pregnant women with S. LDH levels>800 IU/l, whereas with S. LDH<00 IU/l delivered at around 37 weeks of gestation. Mean Apgar scores were lowest for the babies born to hypertensive pregnant women>800 IU/l, mean±SD Apgar scores at the end of 1 min, 5 minutes and 10 min were 4.42±0.79, 4.75±2.26 and 5.50±2.65 respectively.Conclusions: It can be concluded that S. LDH has the potential to be considered as a screening tool or predictor of the outcome of pregnancy in women with hypertensive disorders of pregnancy. However, studies of larger magnitude may be required to confirm the presence and the strength of association of S. LDH levels with pregnancy outcome.

scholarly journals Lactate dehydrogenase levels in preeclampsia and its correlation with maternal and perinatal outcome

2019 ◽  
Vol 8 (4) ◽  
pp. 1505
Author(s):  
Nirmala Bhandari ◽  
Anjali Gupta ◽  
Simmi Kharb ◽  
Meenakshi Chauhan
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Serum Lactate Dehydrogenase ◽  
Hypertensive Disorder ◽  
Perinatal Complications ◽  
Maternal Complications ◽  
Singleton Pregnancy ◽  
Intracellular Enzyme ◽  
Potential Marker

Background: Hypertensive disorder of pregnancy occurs in approximately 6-8% of all pregnancies. The most serious consequences for the mother and the baby are the result of preeclampsia and eclampsia. Lactate Dehydrogenase (LDH) is an intracellular enzyme. Recently LDH has been suggested as potential marker to predict severity of pre-eclampsia. The objective of the present study was to compare the serum lactate dehydrogenase levels in women with preeclampsia and normal pregnant women and to correlate lactate dehydrogenase levels with maternal and perinatal outcome in preeclampsia.Methods: An observational prospective study was conducted on 200 antenatal women attending the labour room emergency. Women with singleton pregnancy and cephalic presentation, from 28 weeks onwards were enrolled in the study. Out of 200, 100 were normal pregnant women and 100 were preeclamptic women. Serum LDH levels were measured in all women and maternal and perinatal outcome was assessed in terms of LDH levels.Results: Higher levels of LDH was observed in pregnant women with preeclampsia (627.38±230.04 IU/l) as compared to normal pregnant women (224.43±116.61 IU/l). The maternal complications were found to be maximum in women with LDH > 800 IU/l.  Abruption was the most common complication. The perinatal mortality and neonatal deaths were found to have significant correlation with high LDH levels.Conclusions: Maternal and perinatal complications were associated with higher LDH levels in preeclampsia patients. Serum LDH levels can be offered to all patients of preeclampsia and can be used to predict the prognosis of preeclampsia.

scholarly journals Maternal Serum Uric Acid as a Predictor of Severity of Hypertensive Disorders of Pregnancy: A Prospective Cohort Study

2019 ◽  
Vol 15 (2) ◽  
pp. 154-160
Author(s):  
Naina Kumar ◽  
Amit K. Singh
Keyword(s):  
Uric Acid ◽  
Serum Uric Acid ◽  
Gestational Hypertension ◽  
Tertiary Care ◽  
Mode Of Delivery ◽  
Maternal Serum ◽  
Hypertensive Disorder ◽  
Hypertensive Disorders Of Pregnancy ◽  
Tertiary Care Centre ◽  
Hypertensive Disorder Of Pregnancy

Objective: To assess the relationship between maternal serum uric acid and severity of Hypertensive disorders of pregnancy in a rural tertiary care centre. Materials and Methods: Present study was conducted in Obstetrics and Gynaecology department of rural tertiary care centre of Northern India over seven months (October 2016-May 2017) on 110 women admitted with a Hypertensive disorder of pregnancy (Gestational hypertension, Preeclampsia, Eclampsia) at ≥;34 weeks gestation. Maternal serum uric acid levels were compared in three groups in relation to disease severity, mode of delivery, maternal outcome. Results: Of total 110 women with a Hypertensive disorder of pregnancy; 35 (31.81%) had Gestational Hypertension, 49 (44.54%) preeclampsia and 26 (23.63%) had eclampsia. Mean±SD values for serum uric acid were 5.47±1.93 mg/dl in women with Gestational Hypertension; 6.72±2.15 mg/dl in Pre-eclampsia and 8.71±2.97 mg/dl in the eclamptic group. Of 110 women 34(97.14%) with gestational hypertension, 27(55.10%) with pre-eclampsia and one (3.85%) with eclampsia remained stable in post-partum period, 17 (34.69%) women with severe pre-eclampsia and 15 (57.69%) with eclampsia required intensive care in postpartum period and one (2.86%) women with gestational hypertension, five (10.20%) with pre-eclmapsia and ten (38.46%) with eclampsia required ventilator support and high dependency unit care. Of these 16 women with the severe disease, ten succumbed to death. Also, in women with serum uric acid,>6mg/dl, most common mode of delivery was a lower segment cesarean section (50.90%). Conclusion: Significant correlation was observed between maternal serum uric acid, disease severity and maternal outcome.

scholarly journals A correlation of lactate dehydrogenase enzyme levels in pregnancy induced hypertensive disorders with severity of disease, maternal and perinatal outcome

2017 ◽  
Vol 6 (10) ◽  
pp. 4302 ◽  
Author(s):  
Neha V. Bhave ◽  
Parmanand K. Shah
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Vascular Function ◽  
Perinatal Outcome ◽  
Gestational Hypertension ◽  
Hypertensive Disorder ◽  
Severity Of Disease ◽  
Hypertensive Disorders ◽  
Dehydrogenase Enzyme ◽  
In Pregnancy

Background: A spectrum of hypertensive disorders in pregnancy contribute to maternal and perinatal morbidity and mortality. For prediction and early diagnosis of preeclampsia various biochemical markers, vascular function test and renal markers have been developed. The objective of the study is to measure the lactate dehydrogenase enzyme (LDH) levels in pregnant women with pregnancy induced hypertensive disorders and correlate the levels with the severity of condition, maternal and the perinatal outcome.Methods: In this prospective observational study, a total of 150 pregnant women were studied. Out of these 150 women, 30 women had normal blood pressure, 30 women had gestational hypertension, 30 women had mild preeclampsia, 30 women had severe preeclampsia and 30 women had eclampsia. The serum LDH levels were measured in third trimester and patients followed up until early postpartum period and babies were followed up till early neonatal period to assess the maternal and neonatal outcomes.Results: Higher lactate dehydrogenase enzyme (LDH) levels were observed in pregnant women with severe form of hypertensive disorder and those who had a poor maternal and perinatal outcome. This is statistically significant (p<0.001).Conclusions: Lactate dehydrogenase enzyme (LDH) level is a useful biochemical marker to assess and predict the severity of disease, maternal and perinatal outcome as higher levels of the enzyme are associated with worsening severity of disease, a poor maternal and perinatal outcome.

scholarly journals Study of caesarean section at tertiary care centre: a retrospective study

2020 ◽  
Vol 9 (5) ◽  
pp. 2138
Author(s):  
Varsha Kose ◽  
Kumari Sadhvi
Keyword(s):  
Retrospective Study ◽  
Caesarean Section ◽  
Tertiary Care ◽  
Fetal Distress ◽  
High Rate ◽  
Audit And Feedback ◽  
Research Centre ◽  
Medical Sciences ◽  
Tertiary Care Centre ◽  
Failure Of Induction

Background: Caesarean section (C-section) is one of the most widely performed surgical procedure in obstetrics worldwide. The WHO guidelines revised in 1994 states that the proportion of C-section birth should range between 5-15% but both in developed and developing countries C-section rate is on the rise. This study was conducted to analyse the frequency and indications for C-section and associated maternal morbidity and mortality.Methods: This retrospective study was conducted over a period from January 2018 to May 2019 at the department of obstetrics and gynecology, NKP Salve Institute of Medical Sciences and Research Centre and Lata Mangeshkar Hospital, Hingna, Nagpur, Maharashtra, India. Data of patients who delivered by C-section in our hospital during the defined study period were studied and statistically analysed according to various parameters namely, the frequency of caesarean section, its indications, age, parity and gestational age of the patient.Results: The total number of women delivered over the study period were 2811. Out of which C-sections were done in 1461 women (51.97%). Previous C-section was the leading indication in 35.72% women followed by fetal distress 14.09%, failure of induction 12.93%, arrest of labour 7.93%, PIH 7.18%, oligo/IUGR 6.50%, breech 4.44%, refusal of vaginal birth 4.24%, CPD 1.71%, bad obstetrics history (BOH) 1.43%, malpresentation 1.30%, prematurity 1.23%,  and multifetal gestation in 1.09% women. Two women had classical C-section 0.07. 14.09% women had various complications. There was no maternal mortality.Conclusions: A high rate of caesarean deliveries was observed. Individualization of the indication and careful evaluation, following standardized guidelines can help us to limit C-section. Audit and feedback are the best way to judge clinical practice and to reduce the frequency of caesarean section in any tertiary setup.

scholarly journals PREVALENCE, ASSOCIATED FACTORS AND ROLE OF VITAMIN D AND GLUTATHIONE REDUCTASE OF PRE-ECLAMPSIA IN PREGNANT WOMEN

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Simerpreet Kukreja
Keyword(s):  
Fatty Acids ◽  
Vitamin D ◽  
Pregnant Women ◽  
Glutathione Reductase ◽  
Gestational Hypertension ◽  
Multiple Pregnancy ◽  
Vitamin D Supplementation ◽  
Research Centre ◽  
Biochemical Basis

Introduction: In maternal and neonatal cases, preeclampsia is a multi-organ, heterogeneous pregnancy condition associated with significant morbidity and mortality. Since preeclampsia is a progressive disease, in some cases, delivery is necessary to stop the progression to the benefit of the mother and foetus. However, the need for early delivery has adverse effects on significant neonatal outcomes that are not limited to the most premature babies. The results include oxidative stress in the disease and invoke the biochemical basis for antioxidant clinical trials to prevent and treat hypertension caused by pregnancy. In the management of preeclampsia, supplementation of antioxidants along with polyunsaturated fatty acids, particularly omega-3 fatty acids, may be useful. This describes vitamin Ds potential role in the pathogenesis of preeclampsia. However, the role of vitamin D supplementation and dosing is controversial in preventing preeclampsia. Method: The study was carried out from March 2019 to April 2020 at Shalinitai Meghe Hospital and Research Centre using institutional-based cross-sectional study design among women whose age was greater than or equal to eighteen. Data were collected using a standardised and pretested questionnaire from 150 participants by face-to - face interview technique. Using Chemiluminiscent Immunoassay (CLIA), vitamin D estimation was performed. The behaviour of Glutathione Reductase was calculated according to the Goldberg et al 1983 procedure. To classify the factors associated with the development of preeclampsia, logistic regression analysis was used. Result: With a mean age of 30.28, a total of 150 participants were enrolled in the study. Evaluation of vitamin D and glutathione levels The prevalence of preeclampsia among current pregnant women attending ANC at Shalinitai Meghe Hospital was 16 with a 95 % CI. The current preeclampsia was significantly correlated with predictive variables such as the age of the respondents, current multiple pregnancy, and history of diabetes mellitus. Conclusion: The findings of this study showed that preeclampsia was present in a large proportion of women. For both urban and rural residents, health seeking actions towards pregnant women should be promoted, offering an opportunity to detect preeclampsia as early as possible and preventing the coming complication of preeclampsia. The role of antioxidants is controversial in the prevention of preeclampsia. Vitamin D deficiency is associated with preeclampsia in a major way. To document the role of vitamin D supplementation in the prevention of preeclampsia, further studies are required.  Keywords: Gestational hypertension, Pre-eclampsia, Vitamin D, GSH

CLINICAL CHARACTERISTICS AND FETO-MATERNAL OUTCOMES IN PREGNANT WOMEN WITH COVID -19 INFECTIONS

2021 ◽  
pp. 30-32
Author(s):  
Gulshan Bano ◽  
Anubha Prashad ◽  
Rakhee Soni ◽  
Mohammed Mishal
Keyword(s):  
Pregnant Women ◽  
Cesarean Delivery ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Maternal Outcomes ◽  
Hypertensive Disorder ◽  
Co Morbidity ◽  
Hypertensive Disorder Of Pregnancy ◽  
The Mean ◽  
In Pregnancy

Background and objectives:-COVID-19 is ongoing pandemic, caused by novel Corona Virus. There is very scarce information is available about clinical features and feto-maternal outcomes of COVID-19 in pregnancy. Therefore, this study was aimed to determine clinical characteristics and feto-maternal outcomes of pregnant women with COVID-19. Methods- In this retrospective study, we included all pregnant women admitted with COVID-19 over three months. Clinical features, laboratory ndings and feto-maternal outcomes were assessed.Results:-The mean age of the patients was 24 years. Hypertensive disorder of pregnancy was most common associated co-morbidity. Majority of patients (81%) were asymptomatic. Lymphocytopenia was seen in 58% of the patients and 47% had elevated levels of CRP. All patients who presented in rst trimester had spontaneous abortion. There is relatively higher rate of preterm birth (21%) and cesarean delivery(43%). All the neonates were tested negative for COVID-19. Conclusion;- There is relatively higher rate of cesarean delivery. Overall feto-maternal outcome was good and there was no evidence of vertical transmission.

scholarly journals A Proposed Plan for Prenatal Care to Minimize Risks of COVID-19 to Patients and Providers: Focus on Hypertensive Disorders of Pregnancy

2020 ◽  
Vol 37 (08) ◽  
pp. 837-844 ◽  
Author(s):  
John R. Barton ◽  
George R. Saade ◽  
Baha M. Sibai
Keyword(s):  
Pregnant Women ◽  
Disease Progression ◽  
Complete Blood Count ◽  
Gestational Hypertension ◽  
Epigastric Pain ◽  
Signs And Symptoms ◽  
Health Care Facilities ◽  
Hypertensive Disorder ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders

Hypertensive disorders are the most common medical complications of pregnancy and a major cause of maternal and perinatal morbidity and death. The detection of elevated blood pressure during pregnancy is one of the cardinal aspects of optimal antenatal care. With the outbreak of novel coronavirus disease 2019 (COVID-19) and the risk for person-to-person spread of the virus, there is a desire to minimize unnecessary visits to health care facilities. Women should be classified as low risk or high risk for hypertensive disorders of pregnancy and adjustments can be accordingly made in the frequency of maternal and fetal surveillance. During this pandemic, all pregnant women should be encouraged to obtain a sphygmomanometer. Patients monitored for hypertension as an outpatient should receive written instructions on the important signs and symptoms of disease progression and provided contact information to report the development of any concern for change in status. As the clinical management of gestational hypertension and preeclampsia is the same, assessment of urinary protein is unnecessary in the management once a diagnosis of a hypertensive disorder of pregnancy is made. Pregnant women with suspected hypertensive disorders of pregnancy and signs and symptoms associated with the severe end of the disease spectrum (e.g., headaches, visual symptoms, epigastric pain, and pulmonary edema) should have an evaluation including complete blood count, serum creatinine level, and liver transaminases (aspartate aminotransferase and alanine aminotransferase). Further, if there is any evidence of disease progression or if acute severe hypertension develops, prompt hospitalization is suggested. Current guidelines from the American College of Obstetricians and Gynecologists (ACOG) and The Society for Maternal-Fetal Medicine (SMFM) for management of preeclampsia with severe features suggest delivery after 34 0/7 weeks of gestation. With the outbreak of COVID-19, however, adjustments to this algorithm should be considered including delivery by 30 0/7 weeks of gestation in the setting of preeclampsia with severe features. Key Points

scholarly journals Evaluation of serum lactate dehydrogenase in hypertensive disorders of pregnancy and its comparison with normal pregnancy

2020 ◽  
Vol 9 (8) ◽  
pp. 3270
Author(s):  
Anil Kumar ◽  
Kushla Pathania ◽  
Meenakshi Kandoria
Keyword(s):  
Lactate Dehydrogenase ◽  
Pregnant Women ◽  
Lactic Dehydrogenase ◽  
Serum Lactate ◽  
Morbidity And Mortality ◽  
Serum Lactate Dehydrogenase ◽  
Close Monitoring ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
Subsequent Decrease

Background: Hypertensive disorders of pregnancy and their complications rank as one of the major causes of maternal morbidity and mortality. The objective of the study was to compare the level of serum LDH in normotensive and hypertensive pregnant women and to correlate the levels with maternal and foetal outcome.Methods: Study was conducted in department of obstetrics and gynecology Kamla Nehru State Hospital for Mother and Child, Indira Gandhi Medical College, Shimla w.e.f. 15th July, 2014 to 14th July, 2015. Pregnant women enrolled in the study were divided into following groups: - Group 1- Age and parity matched 202 normotensive pregnant women. Group 2- 202 women with hypertensive disorders of pregnancy as per the inclusion and exclusion criteria. Subjects were also divided according to the serum LDH levels into following groups: LDH <600 IU/L, LDH-600-800 IU/L and LDH >800IU/L. The maternal and foetal outcome was correlated with the serum level of LDH. One-way analysis of variance (ANOVA) and the chi-square test were used to compare the results. Differences were considered significant when p<0.05.Results: Severely preeclamptic and eclamptic patients were significantly younger, with low gravidity and parity. The symptoms and complications of preeclampsia and eclampsia along with perinatal mortality were increased significantly in patients with LDH >800 IU/L as compared with those who had lower levels.Conclusions: Lactate dehydrogenase is a useful biochemical marker that reflects the severity of and the occurrence of complications of preeclampsia and eclampsia. Identification of high-risk patients with elevated levels of lactic dehydrogenase, their close monitoring, and prompt, correct management may prevent these complications, with a subsequent decrease in maternal foetal morbidity and mortality.

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