ENG and hypertensive disorder: Multiple pregnancy causes an increased placental mass or placental hypoxia that possibly leads to the secretion of placental circulating antiangiogenic factors like;- soluble fms-like tyrosine kinase 1(sFlt1) and soluble endoglin (sEng) which antagonize the placental growth factors and vascular endothelial growth factors results in hypertension, protein and maternal syndromes [57].