Microcirculation in women with severe pre‐eclampsia and HELLP syndrome: a case–control study. (11th November 2013)

• Record Type: Journal Article
• Authors: Cornette, J; Herzog, E; Buijs, EAB; Duvekot, JJ; Rizopoulos, D; Hop, WCJ; Tibboel, D; Steegers, EAP
• Is Part Of: BJOG. Volume 121:Number 3(2014:Mar.)
• Page Start: 363
• Page End: 370
• Publication Date: 2013-11-11
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.12475
• Languages: English
• ISSNs: 1470-0328

Abstract

<abstract abstract-type="main" id="bjo12475-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="bjo12475-sec-0001" sec-type="section"> <title>Objective</title> <p>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).</p> </sec> <sec id="bjo12475-sec-0002" sec-type="section"> <title>Design</title> <p>Case–control study.</p> </sec> <sec id="bjo12475-sec-0003" sec-type="section"> <title>Setting</title> <p>University Hospital Rotterdam, the Netherlands.</p> </sec> <sec id="bjo12475-sec-0004" sec-type="section"> <title>Population</title> <p>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.</p> </sec> <sec id="bjo12475-sec-0005" sec-type="section"> <title>Methods</title> <p>Microcirculation was analysed sublingually by a non‐invasive sidestream dark‐field imaging device (SDF).</p> </sec> <sec id="bjo12475-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>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).</p> </sec> <sec id="bjo12475-sec-0007" sec-type="section"> <title>Results</title> <p>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 (<italic>P</italic> = 0.045), MFI (<italic>P</italic> = 0.008), and increased HI (<italic>P</italic> = 0.002) for small vessels, as compared with women with pre‐eclampsia but without HELLP syndrome.</p> </sec> <sec id="bjo12475-sec-0008" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>