Postpartum Hemorrhage-Induced Acute Kidney Injury Following Obstetric Hysterectomy: A Case Report

Pregnancy-related acute kidney injury (AKI) is rare, with hemorrhage and sepsis being its most common causes when it occurs. A 27-year-old multiparous woman presented to our Emergency Department at 37 weeks of gestation at the end of the second stage of labor. Vaginal delivery was completed without complications, however, immediately postpartum, inadequate uterine contraction led to hemodynamic instability. Conservative measures failed to control the hemorrhage, leading to the decision to perform an obstetric hysterectomy to restore stability. The surgical procedure was successful, however, progressive renal dysfunction with rising creatinine levels occurred postoperatively, prompting the initiation of hemodialysis sessions, which continued for six days until the full restoration of kidney function. This report describes the occurrence of AKI as a result of postpartum hemorrhage following vaginal delivery and outlines its key risk factors, in addition to diagnosis and treatment options. Proper understanding of these factors can significantly contribute to ensuring maternal health and optimizing perinatal outcomes.