Objective We wanted to provide evidence for or against the thus far, unaccepted theory that the genesis of pre-eclampsia arises from the maternal venous circulation. We also wanted to assess hepatic perfusion in pre-eclampsia using 3 dimensional ultrasound.

Methods We measured hepatic portal vein flow in 12 women with normal pregnancy and 11 women with pre-eclampsia using standard Doppler ultrasound. We evaluated the three dimensional (3D) indices of hepatic perfusion: flow index (FI), vascular index (VI) and vascularisation flow index (VFI) which are believed to reflect vascularity and flow intensity. Because of small numbers, a non-parametric test was used to test differences between groups.

Results Hepatic portal vein flow was not different between women with normal pregnancy compared to women with pre-eclampsia [228.1 (215.5–270.6) vs. 283.0 (145.9–344.6); p = 0.90]. The 3D indices of hepatic perfusion were as follows [FI; 36.3(30.7–42.5) vs. 39.7 (27.7–44.2), p = 1.00; VI; 11.7 (3.6–21.2) vs. 3.0 (0.5–7.6), p = 0.04; VFI; 4.7 (1.2–8.3) vs. 1.2 (0.1–3.2), p = 0.06 respectively].

Conclusion We were not able to provide evidence in support of the suggestion that the genesis of pre-eclampsia arises from the maternal venous circulation. Because of the wide variability of our data, overall we conclude that there is no difference in the 3D indices of hepatic perfusion in women with pre-eclampsia compared to normal pregnant women.