الفهرس 
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Abstract
This study was carried out on 600 pregnant women at 22-26 weeks of gestation attending to the antenatal care and obstetric clinic department, at the faculty of Medicine, Ain Shams University, Maternity Hospital during the period between January 2010 to October 2010.
Study size:
An assumption that incidence of preeclampsia is from 7-10% and to demonstrate a 30% difference in TNFR2 between normal and preeclamptic pregnant women at a power of 80 and α-error of 0.05 in addition to an estimated DROP at rate of 20% , it had mandated us to include 600 cases to be recruited originally to have 90 cases recruited for the study divided in to 2 equal groups (45 cases each).
Criteria of selected group:
• Primigravida
Exclusion criteria:
• Multigravidas
• Having chronic hypertension
• Having any predisposing conditions for hypertension as (renal disease, cardiac diseases, endocrinal diseases….etc).
Our study was designed to measure the level of circulating soluble serum TNF-R2 to assess its accuracy as a predictor to pre-eclampsia during pregnancy. A total of 90 women were included in the final analysis , finally the enrolled subjects were classified into two groups .
The 2 groups of women were : Group I (n=45) including women who developed pre-eclampsia; and Group II (n=45) including women who remained normotensive and non-proteinuric till delivery.
Both groups were subjected to careful history taking and physical examination, all the cases were subjected to serum collection within 22-26 wks of gestation, the blood was collected into coagulated tubes, centrifuged, and the serum fraction aliquiotted and stored at -20o C for the future studies.
Serum levels of soluble tumor necrosis factor receptor-2 were measured using ELISA technique. The study showed that there were no significant differences between women of both groups concerning age and gestational age at recruitment. The mean value of serum level of TNF-R2 was significantly higher in women who developed pre-eclampsia when compared to women of the control group. Comparing women who develop severe preeclampsia with those who develop mild preeclampsia, significant increase in mean serum TNF-R2 was found in women who develop severe preeclampsia. In addition, there is a significant positive correlation between serum TNF-R2 and each of systolic, diastolic and mean arterial blood pressure.
The best cutoff value of serum TNF-R2 as predictor severe pre-eclampsia was ≥ 3801 pg/ml while it was found that The best cutoff value of serum TNF-R2 as a predictor of mild preeclampsia was ≥ 2866 pg/ml. So it has a higher significant value in prediction of preeclampsia.