Extracellular vesicles (ECVs) are a component of cellular communication and signaling that play a critical role in healthy pregnancy. ECVs are involved in implantation, immune response, vascular formation and function, metabolism, and delivery. Our research into ECVs are as noninvasive testing markers for predicting and monitoring the progress of pregnancy related diseases, including preeclampsia, gestational diabetes, preterm birth, and fetal growth restriction.