This chronic ischemia further amplifies oxidative stress, inflammatory responses, and endothelial dysfunction, intensifying PE severity.[32,33] Furthermore, reduced PlGF levels during the first trimester significantly precede clinical manifestations, underscoring its potential predictive value for identifying patients at risk of severe PE.[33,34] These findings highlighted the potential usefulness of PlGF levels in clinical practice as a biomarker for identifying patients at higher risk of adverse outcomes, enabling earlier and more targeted interventions. Here, PGF is linked to ischemia.