• J Cornette, E Herzog, E A B Buijs, J J Duvekot, D Rizopoulos, W C J Hop, D Tibboel, and E A P Steegers.
• Department of Obstetrics & Gynaecology, Division of Obstetrics & Prenatal Medicine, Sophia Children's Hospital, Rotterdam, The Netherlands.
• BJOG. 2014 Feb 1; 121 (3): 363-70.

ObjectiveTo 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).DesignCase-control study.SettingUniversity Hospital Rotterdam, the Netherlands.PopulationTwenty-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.MethodsMicrocirculation was analysed sublingually by a non-invasive sidestream dark-field imaging device (SDF).Main Outcome MeasuresPerfused 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).ResultsThere 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.ConclusionsSidestream 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.© 2013 Royal College of Obstetricians and Gynaecologists.

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