Role of IDH as a prognostic marker in preeclampsia/eclampsia: a comparative case control study

Background: Preeclampsia is a multisystem disorder which complicates 5-8% of all pregnancies. LDH is an intracellular enzyme and its level is increased in these women due to cellular death. Serum LDH levels can be used to assess the extent of cellular death and thereby the severity of disease in this group of women. Methods: It was a prospective case control study. Data was analysed using SPSS 16.0. The sample comprised of approximately 154 cases. All patients were of gestational age 28 weeks and above. They were divided into three groups 45 normotensives, 40 mild pre-eclamptics, 41 severe pre-eclamptics and 28 eclamptics. Results: Serum LDH levels consistently increased with increasing systolic and diastolic blood pressure, more so with diastolic blood pressure with a p value of <0.001. Most of the women with severe preeclampsia and eclampsia had severe proteinuria and serum LDH significantly increased with the severity of proteinuria (p<0.00). The incidence of operative delivery was moderately elevated with increased LDH level. The mean gestational age at the time of delivery in patients with serum LDH less than 600, 600 to 800 and more than 800 are 37.94 35.36 and 33.87 weeks. The mean baby weight in patients with serum LDH less than 600, 600 to 800 and more than 800 was 2.80, 2.62 and 1.81 kg. Conclusions: Serum LDH values were significantly high in pre-eclamptic patients depending on the severity of the disease. Serum LDH levels had a good correlation with all the diagnostic components of preeclampsia like SBP, DBP and proteinuria, similarly with maternal and fetal morbidity and mortality

A prospective study of maternal outcome of labor and perinatal outcome in premature rupture of membranes

Background: Premature rupture of membranes refers to rupture of fetal membranes prior to the onset of labor. PROM is of two types viz. term PROM and preterm PROM. The incidence of PROM is at an average of 10%. In 70% of the cases, it occurs in pregnancies at term.  Preterm PROM- defined as PROM prior to 37 weeks of gestation- complicates 2% to 4% of all singleton and 7% to 20% of twin pregnancies. It is the leading identifiable cause of premature birth and accounts for approximately 18% to 20% of perinatal deaths. Methods: This study was conducted in the tertiary care teaching institute in the state of Jammu and Kashmir, India. After taking an informed consent, a proforma was filled on subject history, examination and investigations. These subjects were followed until delivery and then neonates were also followed. Results: Incidence of PROM was 8.76% of which 54.7% were primigravida and 45.3% were multigravida. Most of the patients (70.4%) were term, only 29.6% were preterm with gestational age of <37 weeks. Incidence of PPH was 2.8%, puerperal pyrexia occurred in 9.8%. The incidence of RDS in neonates was 8.9% while the incidence of neonatal sepsis was 6.7%. There was 1.1% perinatal mortality. Conclusions: From this study it can be concluded that basic aim of obstetrician should be to identify the risk factors leading to PROM, to treat complications and implement strict aseptic precautions to prevent maternal and neonatal morbidity