Impaired vascular function in women with pre-eclampsia observed with orthogonal polarisation spectral imaging

Objective To investigate in vivo the function of the microcirculation of th e skin in pregnancy and pregnancy complicated with pre-eclampsia. Design Case-control study. Setting Academic Medical Centre. Participants A group of 10 women with pre-eclampsia and a healthy control g roup Of 10 pregnant women. Methods The microcirculation of the skin of the finger at rest and during v enous occlusion was studied with laser Doppler fluxmetry and orthogonal pol arisation spectral imaging. By inflating a cuff around the upper arm to a p ressure of 50mmHg, causing venous occlusion, the local sympathetic veno-art eriolar reflex was provoked. With laser Doppler fluxmetry the blood flow of the skin at a depth of 1-2mm was measured at rest and during venous occlus ion. Orthogonal polarisation spectral imaging was used to assess red blood cell velocity at rest and during venous occlusion of the nutritive capillar ies of the skin, Results Laser Doppler fluxmetry showed no significant difference between th e normotensive group and the group with pre-eclampsia. Using orthogonal pol arisation spectral imaging, venous occlusion produced a significantly great er decrease in red blood cell velocity in the control group than in the wom en with preeclampsia: (84% (81-88)(median and interquartile range) vs 58% ( 45-88), P = 0,0029). No differences in absolute red blood cell velocities w ere observed between groups either at rest or during venous occlusion. Conclusion This study shows an impaired local veno-arteriolar reflex in pre -eclampsia at the nutritive, but not at the thermoregulatory, level of the microcirculation of the skin.