Abstract
The blastocyst–endometrium interaction requires the perfect synchronization between the development of the embryo and the maturation of the endometrium. The trophoblast starts to invade the decidua and the spiral arteries, forming trophoblastic plugs. These plugs explain why the beginning of placentation and the development of the fetus occur in a hypoxic environment with trophoblastic invasion of the inner third of the myometrium and the physiological transformation of the spiral arteries in this region. Recent studies indicate that many abnormalities in the physiopathology of pre-eclampsia are similar to those in atherosclerosis. The risk factors of this disorder are heterogeneous and are, once more, frequently associated with atherosclerosis. Pre-eclampsia is currently regarded as a two-stage disease: the uteroplacental circulation remains in a high-pressure regimen, corresponding to the first stage of the disease. The second stage includes the maternal response in which there is global activation of inflammatory systems and dysfunction of endothelial cells. We believe that flow-mediated vasodilation can become a simple, non-invasive method of predicting pre-eclampsia, therefore increasing the predictive value of the Doppler of the uterine arteries.