Study of Liver Enzymes Especially Lactate Dehydrogenase to Predict Foetal Outcome in Pregnancy Induced Hypertension

The activity of liver enzymes, namely ALT, AST and LDH was evaluated in 68 cases of Pregnancy induced hypertension along with 56 normal primiparous subjects. The activity of all 3 enzymes were found to be elevated significantly in subjects with Pregnancy induced hypertension with respect to control subjects. Fetal birth weight was found to be significantly decreased in former condition and correlated significantly with the change in liver enzyme activity. The correlation was most in case of LDH activity (Pearson Correlation Coefficient = -0.74, p <.0001). Conditions like APGAR score below 7 at 1 and 5 minute after birth, fetal asphyxia, Intrauterine death were considered as bad fetal outcome. The accuracy of maternal liver enzyme to predict the bad foetal outcome was done by Receiver operating characteristic (ROC) curve. In this case also, LDH activity gave better result (Area under curve: 0.89) than other 2 enzymes (Area under curve 0.80 & 0.74 for ALT & AST respectively). The cut off value for LDH to predict bad fetal outcome was found to be 550 IU/L.