Elevated LDH Levels in PPROM

September 12, 2007

SMFM 27th Annual Meeting 2007

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read the abstract:  Lactate Dehydrogenase (LDH) Isoform Activity in the Vaginal "Pool" - A Marker of Intra-Amniotic Infection in Women with Preterm Premature Rupture of Membranes

Transcript

Alix Boyle: This is Alix Boyle reporting for OBGYN/net. I am here at the SMFM meeting with Dr Lissa Magloire from Yale University. Tell us about your research Dr Magloire.

Lissa Magloire, MD: As you know preterm birth and preterm premature rupture of the membranes is a major cause of neonatal morbidity and mortality. We have studied lactate dehydrogenase or LDH, which is found in all body cells. LDH has been associated with positive amniotic fluid cultures, and it’s elevated in women who have infection in preterm labor and preterm premature rupture of the membranes, or PPROM. We have recently published a paper which showed that LDH is elevated in women who have preterm labor and infection and isoforms of LDH 3, 4 and 5 are also elevated in those instances. We wanted to look at women who broke their water early, or who had PPROM, and compare the findings of LDH in the vaginal fluid versus LDH obtained by abdominal amniocentesis. One of the good things about doing this is that often in women who have PPROM, the fluid is very low and doing an abdominal amniocentesis can be technically challenging. Therefore, this would offer an opportunity for clinicians to obtain the vaginal fluid quickly and easily.

Alix Boyle: What were the results of your research?

Lissa Magloire, MD: We found that in the vaginal fluid the total LDH activity was also elevated as it was in the abdominal, but to a greater fold. We found that the accuracy of the LDH versus the accuracy of the abdominal amniotic fluid LDH were similar, so the sensitivity for having a positive culture was about 70 percent in the both vaginal and the abdominal means of obtaining the amniotic fluid LDH.

Alix Boyle: What does this mean for the future of treating women with PPROM?

Lissa Magloire, MD: This offers an opportunity perhaps to diagnose women quickly who have preterm premature rupture of the membranes in a manner that’s easy for many clinicians. If you don’t have access or don’t have the expertise of doing the amniocentesis you simply can collect the fluid from the speculum and send that to the lab to get the LDH activity.

You know we had about 45 patients in the study, so definitely I would say that larger, prospective trials are needed in order to find out if this would be the optimal way of diagnosing women with infection.

Alix Boyle: That was great. Thank you Dr Magloire.

Lissa Magloire, MD: You’re welcome.