ABSTRACT
A 13 year old adopted girl who was 6 months pregnant was presented with altered consciousness and bleeding from the vagina. Based on the signs and symptoms of edema, severe hypertension and heavy proteinuria, accompanied by the abdominal ultrasound results, she was diagnosed with severe pre-eclampsia /eclampsia complicated by an abruption of the placenta and a dead fetus in utero. These serious conditions resulted in acute renal failure due to both pre-renal and renal causes. With proper management of hypertension and fluid therapy, the renal function returned to normal. Neurological manifestation was transient but complete recovery through psychological testing was in doubt. A multidisciplinary team, including psychiatrist, pediatrician, social worker and legal consultant, was established to address the issue of child abuse and neglect.