الفهرس 
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Abstract
Preeclampsia complicates 2–8% of pregnancies worldwide and is associated with increased risk of adverse outcomes for mother and baby (Duley 2009). Although gross pathologic changes are not always seen in the placentas of women with preeclampsia, placental profiles including abnormal uterine artery Doppler and placental morphology have been used to identify high-risk women who go on to develop the syndrome (Hershkovitz et al., 2005). It is potentially dangerous complication of second half of pregnancy, labor, or early period after delivery. PE currently has little effective therapy, through it largely resolves after placenta and fetus delivery (Powe et al., 2011). PE is one of the most common reasons for induced preterm delivery (Redman et al., 2005). Insulin resistance (IR) plays a major role in Type II diabetes mellitus and in the pathogenesis of hypertension, dyslipidemias, and coronary artery disease. Virtually all-obese women with hypertension have an elevated insulin level (Cunningham et al., 2010) the highest levels occur in obese women with excessive abdominal adipose tissue. (American College, 2003). Insulin resistance is a hallmark of obesity, and in pregnant women, obesity is a consistent risk factor for preeclampsia.
It has been proposed that insulin resistance may be the common denominator for such metabolic changes (Kaaja et al., 1998). Other similarities between insulin resistance syndrome and preeclampsia are endothelial dysfunction, thrombogenicity with abnormalities in platelet function and clotting factors and reduced fibrinolytic activity (Sowers, et al., 1993). Because of changes in lipids, lipoprotein, and other metabolic processes, such as hyperinsulinemia, and hyperuricemia, found in preeclampsia resemble the main features of the insulin resistance syndrome.
Obesity is a major epidemic in developed countries that is now extending to developing countries. (Misra et al., 2008) Obesity increases the risk of all ‘‘forms’’ of preeclampsia. Thus, the risk of severe and mild preeclampsia (Bodnar et al., 2007) and preeclampsia occurring in early and late gestation (Catov et al., 2007) are greater in obese and overweight women.
The objective of the present study was to investigate the glucose tolerance, insulin response, and c-peptide serum level of women with pre-eclampsia compared to women with normal healthy uncomplicated pregnancy, and to correlate the results with the degree of preeclampsia.
The study was conducted at El-Gomhoria Hospital; in Alexandria included 60 pregnant women subdivided into 2 groups:
1. GROUP 1 (Control group): consisted of 30 normotensive women.
2. GROUP 2 (Study group): divided into 2 subgroups:
a. Group 1a: 20 cases with mild preeclampsia.
b. Group 1b: 10 cases with sever preeclampsia.
• History taking, a full clinical examinations (general and obstetric examination) and routine investigations were conducted in all cases.
• General and obstetrical examinations.
• Blood pressure of the selected candidates was measured at two different occasions 6 hours apart estimated using standard mercury sphygmomanometer.
• Morning urine sample for proteinuria by dipstick method.
• Body mass index for control and studied groups (BMI – weight kg/ (height) m2).
• Oral glucose tolerance test was performed in all cases. The serum
insulin, serum C-peptide, uric acid.
The current study has shown that there were no statistically significant differences between two groups regarding to the patient parity, age and gestational age. Also there were statistically insignificant differences between two groups regarding fasting blood glucose, 1-hour after 75-g glucose, 2-hours after 75-g glucose and uric acid.
In contrary there were statistically significant differences between two groups regarding to;
Mean arterial blood pressure, systolic blood pressure, and diastolic blood pressure. Also BMI show statistically significant difference between two groups. There were statistically significant differences between two groups regarding serum C- peptide, serum insulin and protein in urine.
There was insignificant negative correlation between BMI with serum C-peptide and protein in urine, serum insulin and parity. There was insignificant positive correlation between BMI and clinical data for gestational age and maternal age, while there was significant positive correlation between BMI versus SBP, DBP and MABP.