Evaluation of serum lactate dehydrogenase and gamma glutamyl transferase in preeclamptic pregnancy and its comparison with normal pregnancy in third trimester

Purnima Dey Sarkar, Sonal Sogani


Background: Preeclampsia affects about 5-8% of all pregnancies and is a major cause of maternal, fetal and neonatal mortality and morbidity. Evidences prove that endothelial cell and altered endothelial cell function play an important role in the pathogenesis of preeclampsia. Therefore serum lactate dehydrogenase (LDH) and serum gamma glutamyl transferase (GGT) are the useful biochemical markers reflecting the severity of the occurrence of preeclampsia. The objective was todetermine serum lactate dehydrogenase (LDH) and serum gamma glutamyl transferase (GGT) as biochemical markers in preeclamptic pregnant women and its comparison with normal pregnant women in third trimester.

Methods: This is the case-control hospital based study carried in the Department of Biochemistry M.G.M. Medical College and associated M.Y. Hospital. Indore (M.P.). Normal pregnant women (n=48), women with preeclampsia (n=53) were included in the study. Both the groups were in their third trimester and of same age and same gestational age. Preeclamptic group was further divided into two subgroups mild (n=36) and severe (n=17) preeclampsia.

Results: There were no significant differences among the three groups in age and body mass index but significantly higher differences in gestational age, systolic and diastolic blood pressure was observed. Higher values of serum lactate dehydrogenase (LDH) were found in mild and severe preeclamptic women than those of normal pregnant women in third trimester but the values of serum LDH was significantly elevated in severe preeclamptic women when comparison was done between mild and severe preeclamptic women. Serum GGT was significantly higher among all the groups.

Conclusion: Elevated levels of serum LDH and serum GGT indicates the tissue damage related to endothelial vascular damage and are the main cause of the occurrence of preeclampsia.



Preeclampsia, LDH, GGT, Endothelial dysfunction

Full Text:



F. Gary Cunningham, Kenneth J. Leveno, Steven L. Bloom, John C. Hauth, Dwight J. Rouse, Catherine Y. Spong. Williams Obstetrics- 23rded. New York, NY: McGraw-Hill; 2010:706-756.

WHO, 2004. Bethesda, MD. Global Burden of Disease for the Year 2001 by World Bank Region, for Use in Disease Control Priorities in Developing Countries, National Institutes of Health: WHO. Make every mother and child count. World Health Report, 2005, Geneva: World Health Organization, 2005. 2nded.

Stekkinger E, Zandstra M, Peeters LL, Spaandernen ME. Early-onset preeclampsia and the prevalence of postpartum metabolic syndrome. Obstet Gynaecol 2009 Nov;114(5):1076-84.

Kay HH, Zhu S, Tsoi S. Hypoxia and lactate production in trophoblast cells. Placenta 2007; 28(8-9):854-60.

Lopez-Jaramillo P, Casas JP, Serrano N. Preeclampsia: from epidemiology observation to molecular mechanisms. Brazil J Med Biol Res 2001;34:1227-35.

Jan AK, Jamil M. Management of preeclampsia and Eclampsia. JPMI 2000;14(1):67-71.

Pasaoglu H, Bulduk G, Ogus E, Pasaoglu A, et al. Nitric oxide, lipid peroxide and uric acid levels in preeclampsia and eclampsia. Tohoku J Exp Med 2004;202(2):87-92.

Norwitz ER, Hsu CD, Repke JT. Acute complications of preeclampsia. Clin Obstet Gynecol2002;45:308-29.

Page NM. The endocrinology of preeclampsia. Clin Endocrinol 2002;57:413-23.

Qublan HS, Ammarin V, Bataineh O, Al Shraideh Z, Tahat Y, Awamleh I, et al. Lactic dehydrogenase as a biochemical marker of adverse pregnancy outcome in severe preeclampsia. Med Sci Monit 2005;11:CR393-7.

Krefetz RG. Enzymes. Clinical Chemistry,4th ed. Lippincott Williams and Wikins; Philadelphia 2000;196-8.

Malarewicz A, Gruszka O, Szymkiewicz J, Rogala J. The usefulness of routine laboratory tests in the evaluation of sudden threat of pregnant woman and fetus in preeclampsia. Ginekol Pol 2006;77(4):276-84.

Mauro P, Renze B, Wouter W. In: Tietz text book of clinical chemistry and molecular diagnostics.4th edition. Carl AB, Edward R, David EB, editors. Elsevier; 2006. Enzymes; pp.604-616.

Goldberg DM. Structural, functional, and clinical aspects of gamma-glutamyl transferase. CRC Crit Rev Clin Lab Sci 1980;12(1):1-58.

Churchill D, Kilby MD, Bignell A, et al. Gamma-glutamyl transferase activity in gestational hypertension. Br J Obstet Gynecol 1994;101:251-3.