[Changes in microcirculatory reactivity in patients with gestosis]

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.