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Sin embargo, actualmente se la considera una manifestación clínica más de una PE severa (1).\\nSiendo la eclampsia un cuadro de emergencia obstétrica y considerando que se puede presentar más frecuentemente como una complicación de un cuadro de PE severa, podemos pensar que no es factible generar un manejo preventivo, ya que no sabemos la etiología de los cuadros PE, sin embargo se reconocen signos clínicos que son premonitorios de esta emergencias los cuales ya fueron señalados y deben ser pesquisados oportunamente para dar un manejo adecuado de la crisis de Eclampsia. 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La mayor parte de estas complicaciones se resuelve tras el parto pero el daño cerebral producido por hemorragia o isquemia puede dar lugar a secuelas neurológicas permanentes y serán la causa más importante de muerte en mujeres con eclampsia (5).\\nEn este punto es importante reconocer como los cambios propios de la gestación pueden acentuar las complicaciones sistémicas presentes en un cuadro de Eclampsia. Si pensamos en los cambios cardiovasculares, tenemos de base un aumento de la permeabilidad vascular, la cual se acentúa en este cuadro, como consecuencia del daño endotelial que se presenta, este hecho condiciona una complicación mayor, el edema a nivel de diferentes parénquimas entre ellos los más relevantes encéfalo y pulmón. En el sistema hematológico, el embarazo condiciona un aumento de las plaquetas entre uno de tantos cambios, y si lo sumamos a la vasoconstricción existente y el daño endotelial, la presencia de una coagulopatía de consumo, es el resultados de la presencia de estos eventos en forma simultánea. A nivel del sistema respiratorio sabemos que durante la gestación el cambio más significativo es la disminución del volumen residual y de la capacidad torácica, lo cual por si solos no agravan las complicaciones respiratorias presente en la Eclampsia, pero si acentúa el grado de insuficiencia respiratorio, como consecuencia del edema pulmonar y la bronco aspiración presentes en este cuadro. Cabe señalar que una de las complicaciones más relevantes es la insuficiencia renal, a diferencia de lo descrito en los otros sistemas, los cambios que se presentan en el sistema renal durante la gestación van orientados fundamentalmente a favorecer su funcionalidad, al presentarse un aumento de su perfusión presentando un mayor flujo plasmático renal, flujo sanguíneo renal y velocidad de filtración glomerular, sin embargo uno de los eventos que si cobra relevancia, es que durante la gestación está aumentada la secreción de Aldosterona, cuyo efecto final es provocar vasoconstricción. Ahora si recordamos que durante los cuadros de PE severa y de la Eclampsia el flujo renal está disminuido, como consecuencia de la vasoconstricción existente, la secreción de Aldosterona se ve aumentada como respuesta al evento vaso-contráctil, por otro lado el estado de hipovolemia que se presenta en PE y Eclampsia por el daño endotelial, también representan un estímulo para la secreción de Aldosterona. 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La inadecuada tolerancia inmunitaria que resulta de una alteración a la invasión trofoblástica fetal, que ocurre en el primer trimestre del embarazo, esto conduce a la aberrante función placentaria con isquemia y producción de sustancias aun no completamente identificadas.\\nEste posible mecanismo finalmente produce vasoconstricción generalizada, formación de microtrombos en los vasos pequeños, se reduce el volumen plasmático y, por lo tanto, se altera el flujo plasmático en órganos y tejidos. Las alteraciones fisiopatológicas del síndrome HELLP implican la triada: invasión anormal del trofoblasto, mala adaptación-función placentaria y alteración vascular materna generalizada (8).\\nLos signos del síndrome HELLP (hipertensión, proteinuria, elevación de enzimas hepáticas y hemólisis) pueden explicarse por la actividad inflamatoria sistémica que afecta la disfunción de las células endoteliales maternas. La hipertensión con vasoespasmos y alteración endotelial provoca la formación de microtrombos en los pequeños vasos, agregación placentaria y necrosis periportal o focal del parénquima de los hepatocitos (8).\\nOtra característica importante del síndrome HELLP es lo heterogéneo del flujo sanguíneo en los pequeños vasos. El flujo heterogéneo afecta mucho más la oxigenación del tejido, que aquel flujo reducido pero homogéneo. Cornette y sus colaboradores estudiaron la perfusión en la microcirculación de pacientes embarazadas sanas, con preeclampsia severa y con síndrome HELLP, y demostraron con técnicas modernas que la microcirculación sublingual no se encuentra alterada en pacientes con embarazos normales o con preeclampsia severa; sin embargo, en quienes tienen síndrome HELLP se altera la perfusión capilar (8).\\nEs importante señalar algunos aspectos clínicos que son importantes reconocer en el Síndrome de Hellp porque además permiten hacer la diferencia con cuadros similares o asociados, que podrían retrasar un diagnóstico oportuno, lo cual claramente favorece la presencia de agravamiento del cuadro y la instalación de una emergencia obstétrica.\\nDentro de los hallazgos clínicos se reconoce que las pacientes con síndrome HELLP pueden tener los mismos signos y síntomas que se presentan en preeclampsia-eclampsia; sin embargo, también pueden encontrarse diferentes hallazgos clínicos a los que casi siempre se manifiestan en este síndrome. 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Se piensa que la hematuria es un signo característico en pacientes con síndrome HELLP clase 1 (severo). En casos excepcionales se ha observado hematuria en pacientes con preeclampsia-eclampsia. En cuanto al grado de hipertensión, aunque cerca de 90^%^ de los casos la padecen, ésta puede ser leve en 15 a 50^%^ de los casos y estar ausente en 10^%^ de las pacientes con el síndrome. 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