By PPH Foundation

When conversations about maternal health focus on childbirth emergencies, the most immediate concern is often survival. Postpartum haemorrhage, one of the leading causes of maternal death worldwide, demands rapid medical attention as healthcare workers race to stop the bleeding and stabilize the mother.

Yet for many women, surviving severe bleeding may only be the beginning of another silent health threat.

Maternal health experts have drawn attention to a lesser-known complication of obstetric emergencies, pregnancy-related acute kidney injury, commonly referred to as PRAKI.

Postpartum haemorrhage, often abbreviated as PPH, occurs when a woman experiences severe blood loss after childbirth. According to the World Health Organization, PPH accounts for nearly 30 percent of maternal deaths globally, making it the leading direct cause of maternal mortality in many countries.

But the danger does not always end once the bleeding stops.

When a woman loses large amounts of blood rapidly, her blood pressure can fall dramatically. This sudden drop reduces the flow of oxygen-rich blood to vital organs, including the kidneys. Without adequate oxygen and circulation, kidney tissues can become damaged.

According to research published in PubMed and supported by studies from the International Society of Nephrology, severe obstetric complications such as postpartum haemorrhage, hypertensive disorders like preeclampsia and eclampsia, and severe infections are among the most common causes of pregnancy-related acute kidney injury.

The kidneys are remarkably active organs. In a healthy adult, they filter roughly 180 litres of blood every day while maintaining the delicate balance of fluids, salts, and waste products in the body. During pregnancy, their role becomes even more critical as the mother’s body adapts to support both her own health and that of the developing baby.

But when severe bleeding occurs, the kidneys are among the first organs to suffer.

“When blood flow to the kidneys drops, even briefly, it can trigger acute kidney injury,” explain several studies in the journal Kidney International. “The damage may appear hours or even days after the obstetric emergency.”

One of the challenges in addressing PRAKI is that it is often underdiagnosed. During childbirth emergencies, the immediate focus of clinicians is naturally on saving the mother’s life and stabilizing the newborn. Once the crisis passes, kidney function may not always be monitored closely unless symptoms become obvious.

Yet the warning signs of kidney injury can be subtle.

Women may experience reduced urine output, swelling in the legs or face, persistent fatigue, shortness of breath, or abnormal laboratory results indicating rising creatinine levels. Without timely diagnosis and treatment, acute kidney injury can progress into long-term kidney disease.

Fortunately, early detection can significantly improve outcomes.

Simple clinical measures such as monitoring urine output, checking kidney function through blood tests, and ensuring follow-up care after severe obstetric complications can help identify problems before permanent damage occurs.

The message for World Kidney Day is clear. Maternal survival should not only mean surviving childbirth but also protecting the long-term health of mothers.

Strengthening obstetric care systems, ensuring access to blood transfusions, and integrating kidney monitoring into emergency maternal care protocols could help reduce the burden of pregnancy-related kidney injury.

For millions of women around the world, the health of the kidneys may depend on how quickly and effectively childbirth complications are recognized and treated.

Saving mothers from postpartum haemorrhage remains a critical goal. But safeguarding the organs that sustain life after childbirth is equally important.

Sources

• World Health Organization
• International Society of Nephrology
• PubMed
• Kidney International Journal
• American Society of Nephrology
• Image by DC Studio on Freepik</a>