Evaluation of Serum Lactate Dehydrogenase and Electrolyte Levels Among Preeclamptic Women at the University of Gondar Comprehensive Specialized Hospital, Northwest, Ethiopia: A Comparative Cross-Sectional Study.

Background: Serum lactate dehydrogenase is a sensitive marker of hypoxia and cellular damage/death in preeclampsia due to vascular endothelial dysfunction. Evaluation of serum electrolytes can also indicate the severity of preeclampsia since it is a vascular endothelial disorder. However, in Ethiopia, there is a lack of data regarding the serum levels of lactate dehydrogenase and electrolytes among preeclamptic patients in comparison with apparently healthy normotensive pregnant women.

Method: A hospital-based comparative cross-sectional study was conducted with 128 participants (64 preeclamptic women and 64 apparently healthy normotensive pregnant women) from October 20, 2021 to January 3, 2022. Preeclamptic women were further classified into 32 without severe features and 32 with severe features. Blood samples (5 mL) were collected, and a Beckman Coulter 700 AU chemistry analyzer was used to measure serum LDH and electrolyte levels. The data were analyzed using SPSS version 25. One-way ANOVA was run to examine the mean variations, and the receiver operator characteristic curve was used to determine the potential diagnostic value for preeclampsia. A p value < 0.05 was considered statistically significant.

Result: Preeclamptic women showed a statistically significant elevation of LDH (p < 0.001) when compared with apparently healthy normotensive pregnant women. There was a substantial decrement in serum magnesium (p < 0.001), calcium (p < 0.001), and potassium (p = 0.029) in preeclamptic women than apparently healthy normotensive pregnant women. There was also a significant elevation of LDH (p < 0.001) but a reduction of calcium (p < 0.001) and potassium (p = 0.021) in preeclampsia with severe features than preeclampsia without severe features. Serum LDH detected preeclampsia with excellent accuracy (97.5%) at ≥ 350 U/L. Serum magnesium, calcium, and potassium demonstrated diagnostic accuracies of 69.5%, 82.3%, and 61%, respectively, for identifying preeclampsia, with optimal cutoff values of ≤ 1.505 mg/dl for magnesium, ≤ 8.65 mg/dl and 8.75 mg/dl for calcium, and 3.5 mmol/l and 3.75 mmol/l for potassium.

Conclusion: Serum LDH was significantly increased in the preeclamptic group compared with normotensive controls. There were significantly decreased levels of serum electrolytes (magnesium, calcium, and potassium) in preeclamptic women. Therefore, it is better to focus on the measurement of serum LDH and electrolytes for early detection and effective management of preeclampsia.