OBJECTIVE: Our purpose was to test the hypothesis that the HELLP (hemolysis, 
elevated liver enzymes, and low platelets) syndrome is the result of excessive 
vasoconstriction of the hepatic arterial circulation.
STUDY DESIGN: Doppler ultrasonography was used to measure the pulsatility index 
of the common hepatic artery in 14 women with preeclampsia, 15 with preeclampsia 
complicated by HELLP syndrome, and 8 with HELLP syndrome but without 
proteinuria. Gestational age ranged from 24 to 38 weeks. The study group was 
compared with a reference group (n = 42).
RESULTS: Both in preeclampsia and in the HELLP syndrome the hepatic artery 
pulsatility index values were significantly increased compared with the 
reference group. However, no significant differences were found between the 
preeclamptic group, the HELLP group with proteinuria, and those with HELLP 
without proteinuria.
CONCLUSIONS: These findings indicate that hepatic artery resistance to blood 
flow is increased in preeclampsia in the presence or absence of the HELLP 
syndrome. The results also demonstrate that vasoconstriction of the hepatic 
arteries is not more pronounced in the HELLP syndrome than in other 
manifestations of preeclampsia. Therefore factors other than vasoconstriction 
are likely to be responsible for the development of the HELLP syndrome.