Preeclampsia is a multisystem disorder affecting 5.8% of primigravidas. It
is a progressive disease with a very variable mode of presentation and rate
of progression. Of all the features of the syndrome, hypertension and preg
nancy-induced proteinuria are the classic clinical manifestations. This dis
ease causes severe complications of the mother and the fetus. Neither are f
actors available for prediction, nor are there strategies for prevention an
d therapy of this disease. The accumulated evidence strongly suggests that
failure or incomplete trophoblastic invasion (end of first, beginning of se
cond trimester) of the spiral arteries, resulting in narrowed spiral arteri
es and subsequent endothelial damage, is responsible for the occurrence of
this disease (third trimester). The reason for trophoblastic failure is not
known. After clinical symptoms have occurred, only symptomatic therapeutic
options are available. In this paper, we discuss potential ways to find sp
ecific and sensitive predictive parameters according to the current knowled
ge of the pathophysiology of this pregnancy-induced severe disorder.