الفهرس 
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Abstract
SUMMARY
Hypertensive disorders of pregnancy (HDP), a group of morbid pregnancy complications, include gestational hypertension, preeclampsia (PE), eclampsia, and chronic hypertension in pregnancy (Cushen and Goulopoulou, 2017).
Among them, PE is the most common disorder characterized by new-onset hypertension typically after 20 weeks of gestation, accompanied by multisystem signs or symptoms, including proteinuria, elevated liver enzymes, renal insufficiency, thrombocytopenia, pulmonary edema, persistent severe headache, seizures (eclampsia), and even maternal and fetal death. PE is one of the leading causes of maternal and perinatal morbidity and mortality(Bulletin, 2019).
Increased pre-pregnancy body mass index (BMI) is associated with increased risks of PE, particularly those women with pre-pregnancy BMI >30 kg/m2.
In this study, we aimed to compare the effect of metformin versus low dose aspirin in prevention of hypertensive disorders in pregnant obese patients.
This randomized control trial was conducted at tertiary care hospital at Beni-Suef University hospital from December 2021 till October 2022 andperformed on total 300 patients with high body mass index (BMI) in first antenatal care visit ≥ 30kg∕m without overt diabetes.
The analysis was based on the data of 300 patients with high body mass index (BMI) in first antenatal care visit ≥ 30kg∕m divided into three groups of Metformin, Aspirin and Control group.
Our study results revealed that maternal weight gain during pregnancy at weeks 30 and 34statistically was significantly lowest in metformin group.
Our study results revealed that gestational diabetes was least frequent in metformin group and most frequent inaspirin and control group., the differences were statistically non significant .
Our study results revealed that Hypertensive disorders of pregnancy , gestational hypertensionandPreeclampsiawereleast frequent in metformin group, followed by aspirin group and most frequent in control group, the differences statistically were significant between control and each of Metformin and Aspirin groups.
Regarding preterm labour, intrauterine growth restriction wereleast frequent in metformin group, followed by aspirin group and most frequent in control group, the differences statistically were non significant.but significant in preterm labour between metformin and control group.
No neonatal mortality and NICU admission recorded
We concluded that prophylactic therapy with a daily dose of 1.0 g of metformin in pregnant obese women without diabetes mellitus from 12 to 13 weeks of gestation until delivery was associated with less hypertensive disorders, and less neonatal preterm delivery than that observed with control group andless maternal gestational weight gainthan that observed withaspirin and control groups.
We recommend a daily dose of metformin as an alternative to aspirin is recommended in obese pregnant womento decrease weight gain and prevention of hypertensive disorders during pregnancy.