New views on endothelial dysfunction in gestational hypertension and potential therapy targets.

The placenta has vital roles in metabolite exchange, fetal growth, and pre-eclampsia (PE). In this review, we discuss the pathogenesis of hypertension in pregnancy, focusing on four major theories to explain PE, discussing endothelial roles in those theories. We focus in particular on the roles of nitric oxide (NO) and prostacyclin (PGI) in placental endothelium, and propose new hypotheses for the influence and mechanisms of endothelial NO and PGI signaling pathways in PE.