الفهرس 
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Abstract
Preeclampsia is a major obstetric problem and a significant source of maternal and neonatal morbidity and mortality,Preeclampsia is associated with increased risks of placental abruption, acute renal failure, cerebrovascular and cardiovascular complications, disseminated intravascular coagulation, and maternal death. Consequently, early diagnosis of preeclampsia and close observation are imperative.
Delivery of the placenta results in resolution of the condition, implicating the placenta as a central role in the pathogenesis of preeclampsia. This has led to a two-stage theory whose proponents hypothesize preeclampsia to be a systemic syndrome that originates in the placenta and is characterized by maternal wide spread endothelial dysfunction.
Adrenomedullin (ADM), a regulatory peptide with different actions, is expressed in many tissues throughout the body including the adrenal medulla, endothelial and vascular smooth muscle cells, myocardiump and central nervous system
ADM may affect endocrine secretion and immune response to microbial invasion. It was also found to play a role as a modulator of cell growth and to enhance the availability of nutrients to support growth by increasing blood flow. These same attributes of ADM in tumor biologic features may also be vital in pregnancy.
The ADM encoding gene is located on chromosome 11. Recently, much attention has been paid to ADM gene polymorphisms, which may modulate ADM activity and might be involved in the etiology of different diseases. One of the studied polymorphisms is -1984A>G variant in the promoter region of the ADM gene, which probably enhances adrenomedullin transcription and, in consequence, increases ADM concentration.
In these cases of preeclampsia, combination of Doppler flowmetry and adrenomedullin study was done by DNA extraction from blood, amplification of the adrenomedullin gene by PCR and ˃1984G mutation analysis by restriction endonuclease enzyme TaaI.
The aim of this study was to evaluate the association of adrenomedullin gene polymorphism with the development of preeclampsia and its correlation to maternal and fetal outcome in the studied cases.
This study was conducted on a group of 50 pregnant women attended to the Antenatal clinic and selected from the preeclampsia unit of EL- Shatby Maternity University Hospital,
The selected patients were subdivided in two groups:
group A (control group): 25cases of normotensive pregnant ladies
group B (case group): 25 cases of severe preeclamptic pregnant ladies
Routine investigations, adrenomedullin gene polymorphism study and ultrasound biophysical profile and Doppler flowmetry studies, patients were followed up till delivery and complications were recorded results were tabulated and statistically analyzed and compared for both groups.