Early detection of pre-eclampsia provides the opportunity to intervene by correcting its patho-physiological changes and thus this requires increased knowledge about these processes. The ultimate predictor of pre-eclampsia should be able to identify women with an increased risk as early as in the first trimester by using different markers of importance that reflect different aspects of the pathogenesis. These markers should include but not limited to anamnesis risk factors, angiogenic, inflammatory and other biochemical factors, uterine artery Doppler and MAP. The combination of uterine artery Doppler with biochemical factors that reflect different steps of inadequate implantation and/or placentation could provide a predictive test for preeclampsia of a placental origin. The possibilities of prophylactic treatment are limited, since no specific treatment is provided, but for a high risk group antiplatelet drugs, i.e. low dose aspirin, seems to have a relative good effect in preventing or postponing the disorder, at least if the treatment is started early in pregnancy.