Evaluation of creatine kinase and lactic dehydrogenase enzymes for the retrospective diagnosis of perinatal asphyxia

Budensab A H; Veeresh C Katti; S.N. Joshi

Volume : VII, Issue : VI, June - 2017

Evaluation of creatine kinase and lactic dehydrogenase enzymes for the retrospective diagnosis of perinatal asphyxia

Budensab A H, Veeresh C Katti, S. N. Joshi

Abstract :

Objectives: This study was conducted to diagnose perinatal asphyxia in babies delivered outside with a history of poor cry at birth and certain non specific signs of sickness admitted to NICU within 24 hours of birth. Serum CK–MB and LDH levels were done among the cases and compared with controls and their significance in diagnosing perinatal asphyxia retrospectively were studied. Methods: a prospective study was conducted on 30 neonates comprising the cases(babies delivered outside) and 30 neonates comprising the controls (babies delivered intramural) meeting the inclusion and exclusion criteria for one year from November 2013 to November 2014. The blood samples were drawn at 24 and 72 hours of age and sent for analysis. A CK–MB level of above 92.6U/L at 24 hour and 39.15U/L at 72 hour was taken as cut off level and LDH above 580U/L at 24 and 72 hour taken as cut off level. Results: CK–MB and LDH significantly raised in babies with perinatal asphyxia. The cut off CK–MB value of >92.6U/L at 24 hours has sensitively of 96.6% specificity of 86.6% and at 72 hours CK–MB >39.15U/L has sensitivity 83.3% specificity 30%. The cut off LDH value of >580U/L at 24 hours has sensitively of 100% specificity of 80% and at 72 hours LDH >580U/L has sensitivity 83.3% specificity 86.6%. Conclusion: the area under ROC for LDH at 72 hours was 0.935 and area under curve of ROC for CK–MB at 72 hours was 0.778 with not much difference in area under the curve of ROC for CK–MB (0.984) and LDH (0.982) at 24 hours. So we conclude that LDH at 72 hours of life is most accurate at differentiating asphyxiated and non–asphyxiated symptomatic neonates.