DOI: 10.36347/sasjm.2024.v10i01.006

Pages: 40-42

Renal cortical necrosis associated with postpartum hemorrhage is a rare obstetric complication that can lead to end-stage renal disease. We report a case of a 37-year-old woman, admitted for preeclampsia complicated by in utero fetal death, having presented postpartum hemorrhage complicated by a retroplacental hematoma (RPH). She was treated with tranexamic acid to control bleeding. She subsequently presented a severe acute kidney injury (AKI) requiring hemodialysis with, on computed tomography (CT), the presence of bilateral renal cortical necrosis. A renal biopsy showed cortical necrosis lesions associated with glomerular and vascular thrombotic microangiopathy. There was no recovery of renal function, requiring long-term hemodialysis. Renal cortical necrosis, although rare, can occur in some cases of postpartum hemorrhage. Tranexamic acid would be involved and its use should be done with suspicion. The CT scan is an important diagnostic tool. Renal prognosis is poor.