الفهرس 
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Abstract
Hypertensive disorders, including preeclampsia, are very common complications of pregnancy, with an incidence of 5 to 10%. Preeclampsia with severe features contributes disproportionately to maternal morbidity and mortality worldwide. The rate of severe pre-eclampsia has increased more than 3-fold in the past several decades. In the setting of hypertension or preeclampsia and when a severe feature is present, including elevated liver enzymes (greater than or equal to two times the upper limit of normal), the American College of Obstetricians and Gynecologists recommends premature delivery of the fetus due to concern for end-organ injury and maternal harm.
Osteoprotegerin is a glycoprotein cytokine, which acts in cooperation with the receptor activator of receptor activator of nuclear factor κB ligand, and tumor necrosis factor-related apoptosis-inducing ligand. The Osteoprotegerin gene found on chromosome 8 and constitutes 5 exons. Mounting evidence explored that Osteoprotegerin is expressed in vascular smooth muscle cells, osteoblasts and endothelial cells.
Serum Osteoprotegerin levels increase during pregnancy since the placenta represents a potent source of Osteoprotegerin production. However, pregnant women with preeclampsia exhibit higher Osteoprotegerin levels and Osteoprotegerin/receptor activator of nuclear factor κB ligand ratios when compared to normotensive controls, while different Osteoprotegerin gene variants have been reported in early-onset preeclampsia. So, the aim of this study was to Measurement of serum OPG in pre-eclampsia and its relation to severity.
To elucidate our aim, this study was a Case control study was conducted on 60 with preeclampsia features and 30 normal patients who attended to In Ain Shams university Maternity Hospital, during 6 months from august 2023 to January 2024.
All women in this study were divided into three groups as follow: group A (control group): 30 normotensive pregnant women, group B (non severe preeclampsia): 30 pregnant with Non severe preeclampsia features and group C (severe preeclampsia); 30 pregnant with severe preeclampsia features.
Study Intervention: Evaluation: History: Personal and Present history to Exclude medical diseases, Obstetrical history (LMP, EDD, contraception, gravity, and parity) and Drug history, Examination: General condition - vital data – BMI, Investigation: Basic blood tests included Complete blood count, Kidney function tests, Liver function tests and Radiology investigation: 2D ultrasound to confirm gestational age, fetal viability, and to exclude any fetal malformation, retroplacental hematoma or placental abruption).
The results of this study could be summarized as follows:
• There was no significant difference among these studied groups regarding age, birth weight and gestational age (P>0.05).
• Positive albumin was found in 26 (86.67%) of severe patients, in 30 (100%) of non severe patients and in 5 (16.7%) of controls with significant difference among the studied groups (P<0.001). As well as serum osteoprotegerin was significantly increased among severe patients (8.25±3.10) than non severe patients (3.07±0.94) and controls (0.33±0.18), (P<0.001).
• There were no significant among the studied groups regarding outcome (P=0.248).
• ROC curve analysis showed that the cutoff point of serum OPG as a marker of preeclampsia among cases was 2.917ng/ml, with sensitivity of 96.7%, specificity of 46.7% at AUC of 0.952.