It is believed that placental ischaemia during stage 1 may lead to placental production of a soluble factor or factors that cause maternal endothelial dysfunction.1,6 One such anti-angiogenic factor is soluble fms-like tyrosine kinase 1 (sFlt-1), a soluble vascular endothelial growth factor (VEGF) receptor 1, which has binding sites for soluble VEGF and placental growth factor (PlGF). The gene discussed is VEGFA; the disease is endothelial dysfunction.