Resting peripheral blood flow in normal pregnancy and in pre-eclampsia

Multiple organ dysfunction followed by end organ failure occurs in pre-ecla mpsia. While one would intuitively reason that one of the factors contribut ing to the end organ failure is poor nutritional blood flow, this has yet t o be demonstrated. The aim of the present study was to determine whether ch anges in resting nutritional blood flow occur in pre-eclampsia. We used str ain-gauge plethysmography to study calf blood flow in 19 women with pre-ecl ampsia, 13 normal pregnant women and 17 non-pregnant controls. We reasoned that, since the calf comprises mostly skeletal muscle, without anastomotic channels, blood flowing through this region would primarily reflect nutriti ve flow. Calf blood flow was significantly reduced in women with pre-eclamp sia (1.95 +/- 0.9 ml.min(-1).100 ml(-1)) compared with normal pregnant (3.9 +/- 1.4 ml.min(-1).100 ml(-1)) and non-pregnant (3.8 +/- 1.0 ml.min(-1).10 0 ml(-1)) women (P = 0.0004 and P = 0.0005 respectively; ANOVA). Blood flow in pre-eclampsia was also correlated significantly with platelet count as an index of disease severity. In addition, there was a significant negative correlation between blood flow and systolic blood pressure (r = -0.69, P = 0.004) in the women with pre-eclampsia. These findings support the hypothe sis that nutritional blood flow is reduced in pre-eclampsia. We suggest tha t measurement of resting calf blood flow could give a non-invasive index of deterioration of nutritive blood flow to vital organs in pre-eclampsia.