Relationship between Lactate Dehydrogenase and Schistocytes in Patients with HELLP Syndrome

Abstract

Introduction: Hypertensive disorders of pregnancy constitute a high incidence pathology and a significant cause of maternal and fetal morbidity and mortality. Therefore, HELLP syndrome is one of the most feared complications. Objective: Establish the relationship between plasma LDH levels and the presence of schistocytes in peripheral blood smears, as well as clinical symptoms and lab results present in this syndrome. Materials and methods: Descriptive observational study of cut longitudinal, with the clinical records of hospitalized patients with HELLP syndrome in the University Hospital of Los Andes (IAHULA) Merida-Venezuela, period 2011-2021, in a sample of 148 patients with the inclusion criteria. Results: Average age of 27 years, the majority between 26 and 35 (40%). 56.8% presented epigastric pain, 63.5% exalted tendon reflexes, 75% headache, phosphenes in 45.9%, and tinnitus in 39.2%. The mean of LDH was 768.1 I/U and schistocytes were found in all these patients, systolic blood pressure of 141-160 mm/Hg (40.5%), and 56.1% diastolic pressure between 91 and 110 mm/Hg. In 63.5% platelets levels were below 100,000 mm3. It was found that Lactate Dehydrogenase equal to or above 600 IU/l is a risk factor for patients developing HELLP syndrome, who had 6.9 times more likelihood of peripheral blood smear with schistocytes. Conclusion: LDH is important in the follow-up of patients with hypertensive disorders of pregnancy, and its elevation above 600 IU/l, associated with symptoms such as epigastralgia, headache, tinnitus, and phosphenes, is an indicator that a HELLP syndrome has been established.