Pre-eclampsia is an obstetric condition characterized by increased blood pressure above 140/90 mm Hg occurring for the first-time during pregnancy coupled with proteinuria and/or maternal organ dysfunction, after 20 weeks of pregnancy. 1 Pre-eclampsia has been linked to more than 70 000 maternal deaths worldwide annually, the majority occurring in low-income countries (2.8% of live births). 1 The etiology of pre-eclampsia is not fully understood, but there is a consensus that it is related to an abnormality in the placenta resulting in endothelial dysfunction and vascular spasm. 1,2 The nagging concern has always been what causes the placental disease that leads to the