logo

Structural Capillary Rarefaction and the Onset of Preeclampsia

    loading  Checking for direct PDF access through Ovid

Abstract

OBJECTIVE:

To estimate if reduced capillary density (ie, capillary rarefaction) precedes the onset of preeclampsia and if it could play a role in its pathogenesis. Capillary rarefaction is a consistent finding in essential hypertension.

METHODS:

In this longitudinal cohort study, we recruited 322 consecutive white women, of whom 305 women completed the study. We used intravital video microscopy to measure basal (ie, functional) and maximal (ie, structural) skin capillary densities according to a well-validated protocol and measured plasma angiogenic and antiangiogenic factors. Women were studied at five consecutive predetermined visits.

RESULTS:

Preeclampsia occurred in 16 women (mean onset at 35.6±4.8 weeks of gestation), 272 women had normal pregnancies, eight had hypertension, and nine pregnancies were complicated by intrauterine growth restriction. In women with a normal pregnancy, significant reduction in maximal capillary density occurred at 27–32 weeks but had resolved by the puerperium. In contrast, in women who later developed preeclampsia, structural rarefaction was greater and occurred earlier at 20–24 weeks of gestation and persisted into the puerperium. We also found that the change in soluble Endoglin from 11–16 weeks of gestation to 27–32 weeks of gestation was significantly correlated with the change in structural capillary density.

CONCLUSION:

Significant structural capillary rarefaction precedes the onset of preeclampsia and could play a role in its pathogenesis.

LEVEL OF EVIDENCE:

II

Related Topics

    loading  Loading Related Articles

Join Ovid Insights!

Benefits of Ovid Insights Include:

  • Consolidated email digests of the latest research in your favorite topics
  • A personalized dashboard of your topics all on one page 
  • Tools to bookmark and share articles of interest
  • Ability to customize and save your own searches

Register with Ovid Insights »