الملخص العربييعتبر العالم سيموند (1924) هو أول من درس وعرف أمهات الدم وإمكانية حدوث نزف تحت العنكبوتية نتيجة تمزقها.السبب : إن أمهات الدم المخية هي أكثر سبب يؤدي إلى نزف تحت العنكبوتية أما التشوهات الشريانية الوريدية فمسئولة عن 5% فقط . عند الكثير من المرضى وبرغم الفحوص الدقيقة فإننا نعجز عن كشف مصدر النزف ، أحياناً يكون ارتفاع ضغط الدم ، التشوهات الشريانية الوريدية غير المكشوفة وأمهات الدم المتخثرة الصغيرة تكون مسئولة عن البقية .معدل الحدوث :إن معدل حدوث أم الدم ونزيف تحت العنكبوتية يختلف من بلد لآخر . في حين تمثل اليابان وفيلندا أعلى المعدلات (ما يقرب من 200 – 300 / مليون نسمة) فإن الشرق الأوسط وأفريقيا تمثل أقل المعدلات (حوالي 20/ مليون نسمة) .يعتقد الكثيرين أن معدل حدوث نزف تحت العنكبوتية في الشرق الوسط أعلى مما هو معروف ومسجل الآن . ان أسباب مثل عدم الدراية الكاملة بالمرض ، التشخيص الخطأ ، تشابه أعراض المرض من كثير من الأمراض الأخرى وغياب الإحصاء الدقيق وخلل نظام التحويل بين المستشفيات قد ساهمت بشكل كبير في قلة معدلات الحدوث الحالية .Pathological changes occur in preeclampsia eclampsia are very dangerous and include: haemodynamic changes, haemoconcentration, coagulation changes and thrombocytopenia also there are pathological changes in multiorgans e.g. liver, brain and kidney in the form of hepatic rupture, subcapsular hematoma and liver failure, pathological changes in the brain in the form of hypertensive encephalopathy, coma and blindness.HELLPS syndrome usually develops suddenly during pregnancy (27-37 week gestation) or in the immediate pureperium. The diagnosis of HELLP syndrome is most assured in a pregnant patient with signs and symptoms of preeclampsia-eclampsia and a triad of laboratory abnormalities suggesting red cell trauma (H = Hemolysis), hepatic damage and dysfunction (EL = Elevated Liver enzymes) and thrombocytopenia (LP = Low Platelets).HLEEP syndrome classified into true or ”complete” HELLP which is characterized by:1) Moderate to sever thrombocytopenia.2) Hepatic dysfunction.3) Evidence of hemolysis.And partial or ”incomplete HELLP” which missing one or more of the criteria of complete HELLP e.g.: ELLP syndrome (missing hemolysis), EL Syndrome (severe preeclampsia with mildly Elevated Liver enzymes, absent thrombocytopenia).Maternal and perinatal outcomes are progressively worse fore patients with preeclampsia, partial HELLP syndrome and complete HELLP syndrome.A variety of strategies used to prevent or modify the severity of PE have been evaluated e.g. diuretics and other antihypertensive drugs, magnesium, zinc and calcium supplementation, antithrombotic agents, dietary manipulation and antioxidant. In general no of these have been found to be clinically efficacious.Gestational hypertension and mild preeclampsia require good antenatal care so the mother and fetus should be carefully monitored. Daily fetal movement counts usually are combined with regular non-stress tests or biophysical profiles. Ultrasonic determination of fetal weight and volume of amniotic fluid at diagnosis and every three to four weeks after diagnosis may be used to monitor patients.Management of severe preeclampsia usually is termination of pregnancy without delay. Certain studies suggested expectant management of severe preeclampsia in a selected group of women with the aim of improving infant outcome without compromising the safety of the mother.The first priority in the management of eclampsia is to prevent maternal injury and to support respiratory and cardiovascular function.The next step in the management of eclampsia is to prevent recurrent convulsions. Magnesium sulfate is the drug of choice to treat and prevent subsequent convulsions in women with eclampsia.The next step in the management of eclampsia is to reduce the blood pressure to a safe range but at the same time avoid significant hypotension. The objective of treating severe hypertension is to avoid loss of cerebral autoregulation, and to prevent congestive heart failure without compromising cerebral prefusion or jeopardizing utero placental blood flow that is already reduced in many women with eclampsia.