 One of the major stumbling blocks in any research into the pathophysiology of eclampsia is the enrollment of sufficient patients to achieve statistical significance. No single center is capable of completing a study of the scope and nature of that proposed in a reasonable time period. For this reason it is essential that multicenter networks such as the one that we have established be used to their full capacity and supported adequately to allow this to happen. All of the participating institutions in our network deliver in excess of 1500 patients per year. We have shown at the St. Marks and University of Utah sites that enrollment of 2 patients per week is easily attainable with on-site presence and encouragement. We have asked each site to enroll a minimum of 2 patients per week and we expect more from the larger sites Texas Womens Hospital - 8000 deliveries per annum, University of Minnesota Medical Center Hospitals 10 000 patients per annum, Utah HCA facilities 8000 deliveries per annum. Given an enrollment of 2 patients per week from 20 sites we anticipate annual enrollment of at least 2000 patients and that this study can be realistically performed within 5 years. In addition, we expect that as the LAMPET Study gains impetus and information is disseminated within the HCA network of obstetric institutions we will have more sites joining the study. There is an active program within the HCA Perinatal Safety Initiative that rewards facilities for Quality Programs. HCA has started a grading system within its obstetric hospitals that has as its acme Center of Excellence status. This status within the HCA organization confers significant advantages to the facility and is as such a highly sought after designation. One of the components for attaining Center of Excellence status is an active obstetric research program, and we expect that the LAMPET study will be established and ongoing, it will represent an attractive option for centers wishing to gain the Center of Excellence goal. As outlined above there are already a number of the larger HCA facilities that have committed a 0.5 nursing FTE to this project and have been included in the grant application. There are more facilities that have pledged support and committed nursing support but are not eligible for grant funding because of their smaller size and lower potential for enrolling the required 2 patients per week. Despite the fact that they will not be paid anything, their CEOs have committed up to a 0.5 nursing FTE to help these smaller facilities participate. We anticipate that more and more of the smaller hospitals will also join the study as we disseminate the project throughout the company at divisional meetings and national conferences. These particular sites are prepared to participate in this study without any support and we anticipate that as the study progresses and the protocol is disseminated further HCA facilities will sign up simply for the Center of Excellence designation. This will further ensure success of this project. HCA has a Letter of Agreement program that allows any hospital within the system to accept the IRB approval from the St. Marks site, and thus circumvents time-consuming and costly bureaucracy. This will allow individual physicians and groups of practitioners who wish to participate in research to play an active role in a major RCT. Potential Principal Investigators will be able to download the protocol and a template consent from the Study Website for their own use. All consent form and protocol changes that may be made will be vetted by Dr. Belfort to ensure that these are only cosmetic to satisfy the particular needs of that institution. No substantive changes to the protocol or consent form will be allowed. 