 Objectives .
     Definition of preeclampsia .
     Etiology .
     Effect of hypertensive disorder in pregnancy .
     The theory of development of preeclampsia .
     Pathological changes associated with 
      preeclampsia .
     Definition of Eclampsia .
     Management of preeclampsia and Eclampsia 
     Role of antihypertensive .
       the hypertensive disorder are major 
      contributor to maternal and perinatal 
      morbidity and mortality.
      CLASSIFICATION AND DIFINTION.
      Blood pressure reading depends on 
      maternal position and gestational age, it is 
      lower in left lateral position and higher in 
      sitting position, arterial B/P normally decline 
          st       nd
      in 1  ,and 2  trimester and rise to pre 
      pregnant level in the 3rd trimester.
      Cont.
      The diagnosis of hypertension is made 
       when the systolic B/P is equal or greater 
       than 140mmHg or diastolic of greater or 
       equal 90mmHg.
    1. Preeclampsia/ eclampsia.
    2. Chronic hypertension,  If the hypertension 
       is known prior to pregnancy or develops 
       prior to 20 weeks gestation and persist 12 
       weeks postpartum.
     Cont,
     Mostly essential hypertension but small 
      percentage will have secondary 
      hypertension due to renal ,vascular, or 
      endocrinological causes. 
     3-Chronic hypertension with superimposed 
      preeclampsia.
     It is diagnosed when the patient is known to 
      have hypertension and the process is 
      aggravated by pregnancy and usually 
      carries a worse prognosis , it is suspected 
      by new develop of proteinuria or sudden 
      significant increases in B/P or proteinuria 
      after the 20 weeks of pregnancy.