Bilateral postpartum renal cortical necrosis complicated by peripartum cardiomyopathy after postpartum hemorrhage: a case report
Abstract
A 36-year-old woman developed postpartum haemorrhage after an uncomplicated vaginal delivery, followed by disseminated intravascular coagulation, thrombotic microangiopathy, and persistent anuric kidney failure. Contrast-enhanced computed tomography showed bilateral reversal of corticomedullary enhancement, consistent with renal cortical necrosis. Despite kidney replacement therapy and 13 litres of ultrafiltration, she remained oxygen-dependent, prompting cardiac evaluation on postpartum day 11, which revealed severe left ventricular systolic dysfunction (ejection fraction 25%) consistent with peripartum cardiomyopathy. Cardiac function recovered with medical therapy, whereas kidney function remained irreversible, requiring dialysis and transplantation. Renal cortical necrosis and peripartum cardiomyopathy are linked to endothelial dysfunction, yet their coexistence has rarely been reported. Cardiac dysfunction emerged only after substantial fluid removal, arguing against volume overload alone and suggesting a shared postpartum endotheliopathy. Persistent oxygen requirement despite adequate decongestion should prompt early cardiac assessment rather than being attributed to fluid overload alone.
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BibTeX
@article{vanoost2026bilateral,
title = {{Bilateral postpartum renal cortical necrosis complicated by peripartum cardiomyopathy after postpartum hemorrhage: a case report}},
author = {Antoine Vanoost and Nicolas Mollet and Arthur Foulon and Pierre Pommerolle},
journal = {Journal of Gynecology Obstetrics and Human Reproduction},
year = {2026},
month = oct,
doi = {10.1016/j.jogoh.2026.103291},
url = {https://u-picardie.hal.science/hal-05774262v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Bilateral postpartum renal cortical necrosis complicated by peripartum cardiomyopathy after postpartum hemorrhage: a case report
AU - Antoine Vanoost
AU - Nicolas Mollet
AU - Arthur Foulon
AU - Pierre Pommerolle
PY - 2026
DA - 2026/10/01
JO - Journal of Gynecology Obstetrics and Human Reproduction
DO - 10.1016/j.jogoh.2026.103291
UR - https://u-picardie.hal.science/hal-05774262v1
AB - A 36-year-old woman developed postpartum haemorrhage after an uncomplicated vaginal delivery, followed by disseminated intravascular coagulation, thrombotic microangiopathy, and persistent anuric kidney failure. Contrast-enhanced computed tomography showed bilateral reversal of corticomedullary enhancement, consistent with renal cortical necrosis. Despite kidney replacement therapy and 13 litres of ultrafiltration, she remained oxygen-dependent, prompting cardiac evaluation on postpartum day 11, which revealed severe left ventricular systolic dysfunction (ejection fraction 25%) consistent with peripartum cardiomyopathy. Cardiac function recovered with medical therapy, whereas kidney function remained irreversible, requiring dialysis and transplantation. Renal cortical necrosis and peripartum cardiomyopathy are linked to endothelial dysfunction, yet their coexistence has rarely been reported. Cardiac dysfunction emerged only after substantial fluid removal, arguing against volume overload alone and suggesting a shared postpartum endotheliopathy. Persistent oxygen requirement despite adequate decongestion should prompt early cardiac assessment rather than being attributed to fluid overload alone.
SN - 2468-8495
SN - 2468-7847
ER -