ENHANCEMENT OF HEPATIC-ARTERY RESISTANCE TO BLOOD-FLOW IN PREECLAMPSIA IN PRESENCE OR ABSENCE OF HELLP-SYNDROME (HEMOLYSIS, ELEVATED LIVER-ENZYMES, AND LOW PLATELETS)

OBJECTIVE: Our purpose was to test the hypothesis that the HELLP (hemo lysis, elevated liver enzymes, and low platelets) syndrome is the resu lt of excessive vasoconstriction of the hepatic arterial circulation. STUDY DESIGN: Doppler ultrasonography was used to measure the pulsatil ity index of the common hepatic artery in 14 women with preeclampsia, 15 with preeclampsia complicated by HELLP syndrome, and 8 with HELLP s yndrome but without proteinuria. Gestational age ranged from 24 to 38 weeks. The study group was compared with a reference group (n = 42). R ESULTS: Both in preeclampsia and in the HELLP syndrome the hepatic art ery pulsatility index values were significantly increased compared wit h the reference group. However, no significant differences were found between the preeclamptic group, the HELLP group with proteinuria, and those with HELLP without proteinuria. CONCLUSIONS: These findings indi cate that hepatic artery resistance to blood flow is increased in pree clampsia in the presence or absence of the HELLP syndrome. The results also demonstrate that vasoconstriction of the hepatic arteries is not more pronounced in the HELLP syndrome than in other manifestations of preeclampsia. Therefore factors other than vasoconstriction are likel y to be responsible for the development of the HELLP syndrome.