Skin capillary density in pregnancy induced hypertension and normotensive pregnant participants

Mahendra Kumar, Vandana Bansal, Pravin N. Mhatre, Uday Khopkar


Background: Pre-eclampsia is a vascular related disorder of pregnancy, Despite the increasing research efforts in the field, the etiology and pathogenesis of this disorder remain elusive, resulting in failure to develop specific screening, preventive and treatment strategies. Peripheral vasodilatation and angiogenesis are critical components of physiological adaptation in normal pregnancy. Women who have later developed preeclampsia had significant structural capillary density rarefaction early in the pregnancy before the onset of preeclampsia.

Methods: Case control, comparative study was carried out at our institute. 30 pregnant participants were recruited in each group after satisfying the inclusion criteria. Data was collected by using dermatoscope (200X magnification). Statistical analysis was done by non-parametric test- Mann-Whitney test as blood pressure was not normally distributed among participants. Spearman’s correlation coefficient was used to make correlation between skin capillary densities and blood pressures.

Results: On applying Mann-Whitney test, mean rank for systolic and diastolic blood pressure at 20 weeks for both groups were not significant statistically, mean rank for systolic and diastolic blood pressure between 28-36 weeks of gestation for both groups were significant statistically. After testing, skin capillary density came significantly less in hypertensive group as compare to normotensive pregnant participant of same gestational ages. Spearman’s correlation coefficient came negative for systolic and positive for diastolic blood pressure at 28-36 weeks of gestation.

Conclusions: Authors conclude that estimating the skin capillary density provides a potentially useful clinical marker in the prediction of preeclampsia and dermatoscope is an especially attractive clinical tool.


Dermatoscope, Pregnancy induced hypertension, Skin capillary density

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Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet Lond Engl. 2005 Mar 26;365(9461):785–99.

Wagner SJ, Craici IM, Hogan MC, Bailey KR, Garovic VD. The effect of early diagnosis and treatment on maternal and fetal outcomes in patients with HELLP syndrome.BiochemMedica. 2007;61–70.

Meekins JW, Pijnenborg R, Hanssens M, McFadyen IR, van Asshe A. A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. Br J ObstetGynaecol. 1994 Aug;101(8):669–74.

Baumwell S, Karumanchi SA. Pre-eclampsia: clinical manifestations and molecular mechanisms. Nephron ClinPract. 2007;106(2):c72-81.

Hasan KM, Manyonda IT, Ng FS, Singer DR, Antonios TF. Skin capillary density changes in normal pregnancy and pre-eclampsia. J Hypertens. 2002 Dec;20(12):2439–43.

Antonios TFT, Singer DRJ, Markandu ND, Mortimer PS, MacGregor GA. Structural Skin Capillary Rarefaction in Essential Hypertension. Hypertension. 1999 Apr 1;33(4):998–1001.

Debbabi H, Uzan L, Mourad JJ, Safar M, Levy BI, Tibiriçà E. Increased skin capillary density in treated essential hypertensive patients. Am J Hypertens. 2006 May;19(5):477–83.

Antonios TFT, Rattray FM, Singer DRJ, Markandu ND, Mortimer PS, MacGregor GA. Rarefaction of skin capillaries in normotensive offspring of individuals with essential hypertension. Heart. 2003 Feb 1;89(2):175–8.

Kvehaugen AS, Dechend R, Ramstad HB, Troisi R, Fugelseth D, Staff AC. Endothelial Function and Circulating Biomarkers Are Disturbed in Women and Children After Preeclampsia. Hypertension. 2011 Jul 1;58(1):63–9.

Fraser GM, Morton JS, Schmidt SM, Bourque S, Davidge ST, Davenport MH, et al. Reduced uterine perfusion pressure decreases functional capillary density in skeletal muscle. Am J Physiol - Heart Circ Physiol. 2015 Dec 15;309(12):H2002–7.

Nama V, Manyonda IT, Onwude J, Antonios TF. Structural capillary rarefaction and the onset of preeclampsia.Obstet Gynecol. 2012 May;119(5):967–74.

Rusavy Z, Pitrova B, Korecko V, Kalis V. Changes in capillary diameters in pregnancy-induced hypertension. Hypertens Pregnancy. 2015;34(3):307