CHANGES IN MICROCIRCULATORY REACTIVITY IN PATIENTS WITH PREECLAMPSIA

There is increasing evidence in the literature, that the endothelium of the microcirculation as site of production of vasoactive substances (prostacyclin, endothelin and nitric oxide) plays a central role in the pathophysiology of pre-eclampsia. In this investigation, we studied skin microcirculation of the forearm and the volar hand at rest, after a cooling procedure and during reactive hyperemia in 13 patients with pre-eclampsia and 13 healthy pregnant controls. For our measurements we used Laser-Doppler Flowmetry, because this method is non-invasive and of no measurable influence to the microcirculation during measurement. Our main findings were: In pre-eclampsia there is a higher skin vasodilatory reserve during reactive hyperaemia compared to the control group indicating an increased resting vasomotor tone in skin vessels. Vascular reactivity to a vasoconstrictor stimulus (local cooling) was significantly greater in pre-eclamptic patients than in controls. Laser-Doppler Flowmetry is suited to measure alterations in skin vascular reactivity in pre-eclampsia, but there is a wide overlapping range in the results of patients with pre-eclampsia and healthy pregnant controls. A clear distinction between normal pregnancy and pre-eclampsia by Laser Doppler flowmetry is not possible.