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Abstract Hypertensive disorders of pregnancy, including preeclampsia (PET), consist of a broad spectrum of conditions which are associated with substantial maternal and fetal/neonatal morbidity and mortality. The incidence is estimated to be between 3 and 10% of all pregnancies. (1, 2) PET can be defined as the occurrence of new-onset hypertension after 20 weeks of gestation with proteinuria. However, hypertension with multi-systemic signs usually indicative of disease severity in the absence of proteinuria.(6,9) Eclampsia is defined as the presence of new-onset grand mal seizures in a woman with PET. It can occur before, during, or after labor.(9) Although there are still many unanswered questions, the pathophysiology of pre-eclampsia likely involves maternal and fetal / placental factors. (6) The aim of this work was to evaluate the management of PET cases admitted to Shatby Maternity University Hospital from July 2017 to July 2018 and to improve it in order to decrease the incidence of maternal and fetal complications. This study included 500 pregnant PET women, and they categorized to mild and severe forms, after exclusion of cases with essential hypertension, renal disease and systemic lupus erythematosus. All cases were subjected to detailed history taking, general and local abdominal examination, obstetric ultrasound, Doppler ultrasound, laboratory investigations; treatment received (antihypertensive medications, magnesium sulphate (MgSO4) and steroids) and finally follow up till delivery. By the beginning of this study we started with 380 mild cases and 120 severe cases, but the end of the study 50 cases of mild PET were lost during follow up and 70 cases of mild PET converted into severe form. Regarding complications, PET can result in serious fetal/neonatal or maternal complications. As regard fetal/neonatal complications, oligohydramnios was significantly higher in severe cases as it accounted for 65% of severe cases compared to 0.3% of mild cases. Occurrence of IUFD and abruptio placenta is indicator for severity as IUFD accounted for 55.8% of severe cases while abruptio placenta accounted for 66.7% of severe cases. IUGR was sign |