By PPH Foundation

In maternity wards around the world, the moment a newborn cries for the first time often signals relief. For doctors and nurses, it means that the delivery has succeeded. For families, it marks the beginning of a new life.

But sometimes, even after the danger of childbirth appears to have passed, a silent threat remains.

Pregnancy-related acute kidney injury is increasingly being recognized as a serious but underreported complication of pregnancy and childbirth.

Maternal health experts are urging greater awareness of how pregnancy complications, particularly postpartum haemorrhage, can affect kidney function.

According to the World Health Organization, maternal complications such as severe bleeding, hypertensive disorders of pregnancy, and infections continue to drive maternal illness and death worldwide. These same complications also place enormous stress on vital organs including the kidneys.

The kidneys play an essential role in maintaining the body’s internal balance. They filter waste from the blood, regulate fluid levels, and control electrolyte balance. During pregnancy, these organs must work even harder as the mother’s blood volume increases and metabolic demands rise.

In fact, nephrology research shows that kidney filtration rates increase significantly during pregnancy to support both the mother and the developing fetus.

However, this increased workload also makes the kidneys more vulnerable when complications occur.

One of the most dangerous threats is severe bleeding after childbirth. When postpartum haemorrhage occurs, a large volume of blood can be lost within a short period of time. As blood pressure falls, the body struggles to maintain adequate circulation to critical organs.

The kidneys, which depend heavily on stable blood flow, are particularly sensitive to these changes.

Research published through PubMed indicates that postpartum haemorrhage remains one of the leading triggers of pregnancy-related acute kidney injury in low- and middle-income countries. The International Society of Nephrology has also highlighted that PRAKI remains a major contributor to maternal illness where access to emergency obstetric care is limited.

In such situations, kidney damage may develop quickly.

Sometimes the injury is temporary and reversible if detected early. In other cases, delayed diagnosis can result in long-term kidney damage or even the need for dialysis.

Recognising the early warning signs is therefore critical.

Women who experience complications during pregnancy or childbirth should be monitored for symptoms such as reduced urine output, swelling in the body, fatigue, shortness of breath, and abnormal blood test results.

Healthcare providers can detect early kidney stress through simple monitoring measures, including checking urine output and conducting routine laboratory tests that measure creatinine levels.

These tests can reveal whether the kidneys are functioning normally or beginning to struggle.

Preventing pregnancy-related kidney injury ultimately begins with preventing the complications that place women at risk.

Early antenatal care plays a crucial role in identifying high blood pressure, anaemia, and infections that could lead to serious complications during childbirth. Equally important is ensuring that health facilities are equipped to respond rapidly to emergencies, including managing postpartum haemorrhage and providing safe blood transfusions.

For families and communities, supporting pregnant women to attend regular antenatal care visits and deliver in facilities with skilled birth attendants remains one of the most effective strategies for protecting maternal health.

Protecting mothers from life-threatening complications during pregnancy and childbirth is not only about saving lives in the moment. It is also about preserving the long-term health of the organs that sustain life long after delivery.

Sources

• World Health Organization
• International Society of Nephrology
• PubMed
• Kidney International Journal
• American Society of Nephrology
• Lancet Global Health maternal health studies

Image by freepik</a>