Microcirculation in women with severe pre-eclampsia and HELLP syndrome: a case–control study
Article first published online: 11 NOV 2013
© 2013 Royal College of Obstetricians and Gynaecologists
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 121, Issue 3, pages 363–370, February 2014
How to Cite
Microcirculation in women with severe pre-eclampsia and HELLP syndrome: a case–control study. BJOG 2014;121:363–370., , , , , , , .
- Issue published online: 16 JAN 2014
- Article first published online: 11 NOV 2013
- Manuscript Accepted: 23 AUG 2013
- HELLP syndrome;
- microcirculatory perfusion;
- sidestream dark-field imaging
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).
University Hospital Rotterdam, the Netherlands.
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.
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 (∅ < 20 μm; capillaries) and non-small vessels (∅ > 20 μm; venules and arterioles).
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.
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.