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Editor’s note: While the key to unlocking the precise etiopathology of pre-eclampsia remains elusive, it would seem reasonable to pursue a predictive tool, especially one that could be used in the first trimester to allow the targeting of preventative therapy, such as aspirin and also to identify high-risk groups for the benefit of future research. Several studies have reported that the maternal plasma or serum concentration of cell-free fetal DNA (cffDNA) is two- to 15-fold higher in patients with pre-eclampsia than in normotensive control subjects.