Preeclampsia is defined as progressively worsening high BP in pregnancy that occurs in the setting of proteinuria ( 300 mg of protein in a 24- hour urine specimen).148 Preeclampsia may be of early onset (before 37 weeks gestation) or late onset (after 37 weeks). Eclampsia is preeclampsia that progresses to seizures. Preeclampsia is a multisystem disorder, and abnor- malities such as HELLP (hemolysis, elevated liver enzymes, or low platelets), disseminated intravascular coagulation, acute renal failure, myocardial infarction (MI), pulmonary edema, and stroke may occur. Preeclampsia is hypothesized to be caused by as-yet-unnamed placental factors that enter the maternal circulation, provoking the signs, symptoms, and laboratory findings associated with this disorder.149 Pregnancy-induced (sometimes called gestational) hyper- tension is defined as an elevation in BP, usually near term, that occurs without the other signs and symptoms of preeclampsia. Although gestational hypertension may or may not progress to preeclampsia, it can result in markedly elevated BPs. By defi- nition, gestational hypertension usually resolves by 12 weeks Recognized risk factors for pregnancy-induced hyperten- sion include obesity, age (>40 years), chronic hypertension, personal or family history of preeclampsia or gestational hypertension, nulliparity, multiple pregnancy, preexisting vas- cular disease, collagen vascular disease, diabetes mellitus, and By far the most important predisposing factor is chronic hypertension, because superimposed preeclampsia develops in 25% of pregnant women with this condition. Regardless of its origin, high BP during pregnancy is associ- ated with risk to both mother and baby, and BP-related com- plications remain a leading cause of maternal morbidity and mortality, as well as preterm birth, fetal growth restriction, and Women with high BP during pregnancy who have given birth continue to be at risk for preeclampsia and stroke. 