A Prospective Observational Study on Serum Lactate Dehydrogenase and Uric Acid Levels in Hypertensive Disorders of Pregnancy and Prediction of Fetomaternal Outcome.

Introduction Hypertensive disorders of pregnancy are a major cause of maternal and perinatal morbidity and mortality, particularly in low- and middle-income countries. Early identification of women at risk using simple biochemical markers may aid in timely intervention and improved outcomes. Serum lactate dehydrogenase (LDH) and uric acid have been proposed as indicators of disease severity in hypertensive pregnancies. The study aimed to evaluate the association of serum LDH and uric acid levels with the severity of hypertensive disorders of pregnancy and their relationship with maternal and fetal outcomes in women with hypertensive disorders of pregnancy. Materials and methods This prospective observational study was conducted in a tertiary care teaching hospital from March 2024 to December 2025. A total of 165 pregnant women with hypertensive disorders of pregnancy and gestational age ≥20 weeks were enrolled. Serum LDH and uric acid levels were measured antenatally and after delivery using standard laboratory methods. Normal values were defined as LDH <300 IU/L and uric acid <6 mg/dL. Maternal outcomes included mode of delivery and complications such as hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, disseminated intravascular coagulation, and postpartum hemorrhage. Fetal outcomes assessed included birth weight, preterm delivery, appearance, pulse, grimace, activity, and respiration (APGAR) score, need for resuscitation, and perinatal mortality.  Results The majority of women were aged 21-30 years, and primigravidae constituted the largest group. Elevated serum LDH and uric acid levels were observed in 85.5% (n=141) and 65.5% (n=108) of cases, respectively. Both biomarkers showed a significant progressive rise with increasing severity of hypertensive disorders. Elevated serum LDH levels were significantly associated with adverse fetal outcomes, including low birth weight, need for resuscitation, neonatal death, and preterm birth. Similarly, raised serum uric acid levels showed significant associations with need for resuscitation, neonatal death, and preterm birth. No statistically significant association was observed between elevated biomarker levels and maternal complications. Conclusion Serum LDH and uric acid are valuable, cost-effective biochemical markers that reflect disease severity in hypertensive disorders of pregnancy and can aid in predicting adverse maternal and fetal outcomes. However, their association with maternal complications was not statistically significant in this study.