Objective: To compare microcirculatory perfusion in women with severe pre-eclampsia against that in healthy pregnant women, and secondly in women with severe pre-eclampsia with or without HELLP syndrome (haemolysis, elevated liver enzymes, and low platelets). Design: Case-control study. Setting: University Hospital Rotterdam, the Netherlands. Population: Twenty-three women with severe pre-eclampsia and 23 healthy pregnant controls, matched for maternal and gestational age. Out of the 23 women with severe pre-eclampsia, ten presented with HELLP syndrome. Methods: Microcirculation was analysed sublingually by a non-invasive sidestream dark-field imaging device (SDF). Main outcome measures: Perfused vessel density (PVD), microcirculatory flow index (MFI), and heterogeneity index (HI) were calculated for both small vessels (Ø < 20 μm; capillaries) and non-small vessels (Ø > 20 μm; venules and arterioles). Results: There were no significant differences between women with severe pre-eclampsia and healthy controls. Women with pre-eclampsia and HELLP syndrome showed a reduced PVD (P = 0.045), MFI (P = 0.008), and increased HI (P = 0.002) for small vessels, as compared with women with pre-eclampsia but without HELLP syndrome. Conclusions: Sidestream dark-field is a novel, promising technique in obstetrics that permits the non-invasive evaluation of microcirculation. We did not observe major differences in sublingual microcirculatory perfusion between women with severe pre-eclampsia and healthy pregnant controls. In women with severe pre-eclampsia, the presence of HELLP syndrome is characterised by impaired capillary perfusion.

Additional Metadata
Keywords Capillary, HELLP syndrome, microcirculation, microcirculatory perfusion, pre-eclampsia, sidestream dark-field imaging
Persistent URL dx.doi.org/10.1111/1471-0528.12475, hdl.handle.net/1765/64764
Journal BJOG: An International Journal of Obstetrics and Gynaecology
Citation
Cornette, J.M.J, Herzog, E, Buijs, E.A.B, Duvekot, J.J, Rizopoulos, D, Hop, W.C.J, … Steegers, E.A.P. (2014). Microcirculation in women with severe pre-eclampsia and HELLP syndrome: A case-control study. BJOG: An International Journal of Obstetrics and Gynaecology, 121(3), 363–370. doi:10.1111/1471-0528.12475