ABSTRACT

Decidualization prepares the endometrium for proper embryo invasion and subsequent placentation. Thus, this process is essential for establishing and maintaining a successful pregnancy. Recent research has focused on understanding the role of this endometrial process in pregnancy health. Defective decidualization is linked to causes of infertility, such as endometriosis or recurrent pregnancy loss, and pregnancy complications, such as intrauterine growth restriction or even, preeclampsia. Our working hypothesis is that the quality of the maternal “soil”—the decidua—plays a pivotal role in the etiology of preeclampsia. In this context, our findings reveal a maternal contribution to severe preeclampsia through decidualization resistance that lingers even years after the affected pregnancy. This opens new horizons in the search for early detection and prevention methods since the origin of severe preeclampsia could lie in maternal endometrial health.