PTEN and endothelial dysfunction: This pathway has been extensively discussed in the context of preeclampsia, with PTEN upregulation via the NF-κB pathway inhibiting proper trophoblast invasion and Akt downregulation leading to endothelial dysfunction; as this is another pathway involved in angiogenesis apart from the canonical vascular endothelial growth factor (VEGF), PI3K/Akt/PTEN pathway may play a role in uteroplacental insufficiency in preterm patients (100–102).