Microcirculation in women with severe pre-eclampsia and HELLP syndrome: A case-control study

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.

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See Also
dissertation Preeclampsia and the Development and Programming of Maternal and Newborn Tissues : Clinical and Epigenetic Studies E.M. Herzog (Emilie)
article Author's reply: Microcirculation in women with severe pre-eclampsia and HELLP syndrome: a case control study J.M.J. Cornette (Jérôme)