Endothelial dysfunction is responsible for the clinical signs observed in the mother, ie, impairment of the hepatic endothelium contributing to onset of the HELLP (Hemolysis, Elevated Liver enzymes and Low Platelet count) syndrome, impairment of the cerebral endothelium inducing refractory neurological disorders, or even eclampsia. Depletion of vascular endothelial growth factor in the podocytes makes the endotheliosis more able to block the slit diaphragms in the basement membrane, adding to decreased glomerular filtra- tion and causing proteinuria. Finally, endothelial dysfunction promotes microangiopathic hemolytic anemia, and vascular hyperpermeability associated with low serum albumin causes edema, particularly in the lower limbs or lungs.