Here are the key postpartum emergency conditions to be aware of — these matter clinically since early recognition dramatically changes outcomes:

Postpartum Haemorrhage (PPH)

The most common serious postpartum emergency — defined as blood loss over 500ml (vaginal) or 1000ml (C-section)

• Primary PPH: within 24 hours of birth — most often caused by uterine atony (uterus fails to contract),

• retained placenta, trauma/tears, or clotting disorders

• Secondary PPH: from 24 hours to 12 weeks postpartum — usually due to retained products of conception

• or infection

• Red flags: soaking through a pad in under an hour, large clots, dizziness, rapid heart rate

Pre-eclampsia / Eclampsia (postpartum onset)

• Can develop after birth, even in women with no prior signs during pregnancy —

• most commonly within 48 hours but can occur up to 6 weeks postpartum

• Symptoms: severe headache, visual disturbances, upper right abdominal pain,

• sudden swelling, high blood pressure

• Untreated, can progress to eclamptic seizures or HELLP syndrome (Haemolysis,

• Elevated Liver enzymes, Low Platelets)

Venous Thromboembolism (VTE) — DVT/Pulmonary Embolism

• Pregnancy and postpartum carry significantly elevated clotting risk for up to 12 weeks

• DVT signs: unilateral leg swelling, pain, warmth

• PE signs (medical emergency): sudden breathlessness, chest pain, coughing blood, rapid heart rate

Puerperal Sepsis

• Infection of the genital tract postpartum — can escalate to sepsis rapidly

• Signs: fever, foul-smelling lochia, abdominal pain, rapid heart rate, confusion

• Historically one of the leading causes of maternal death; still requires urgent antibiotic treatment

Postpartum Cardiomyopathy

• Rare but serious heart failure developing in the last month of pregnancy to 5 months postpartum

• Symptoms overlap with normal postpartum fatigue (breathlessness, swelling), which can delay diagnosis — key differentiator is severity/rapid progression and orthopnea (breathlessness lying flat)

Postpartum Psychosis

• A psychiatric emergency (distinct from postpartum depression) — onset typically within the first 2 weeks

• Symptoms: severe confusion, hallucinations, delusions, rapid mood swings

• Requires immediate psychiatric intervention; carries risk to mother and infant safetyUterine Inversion / Rupture

• Rare, but rapid-onset and severe when they occur — usually intrapartum or immediately postpartum, associated with sudden severe pain, haemorrhage, and shock