SYMMETRICAL PERIPHERAL GANGRENE IN THE POSTPARTUM PERIOD: A RARE AND DEVASTATING COMPLICATION
DOI:
https://doi.org/10.54112/pjicm.v5i02.96Keywords:
Symmetrical Peripheral Gangrene, Postpartum Complications, Sepsis, DIC, AmputationAbstract
Background: Symmetrical Peripheral Gangrene (SPG) is a rare but life-threatening condition marked by ischemic necrosis of extremities without major vessel occlusion. It is often associated with disseminated intravascular coagulation (DIC), sepsis, or vasopressor use. Case Presentation: We report a case of a 35-year-old woman who developed SPG in both feet and the right hand after a spontaneous vaginal delivery at home. She developed fever and abdominal pain one week postpartum and subsequently received intravenous antibiotics and two blood transfusions at a private facility. Shortly after the second transfusion, she developed progressive discoloration and pain in her extremities. She was eventually diagnosed with SPG and underwent a below-knee amputation. Conclusion: This case highlights the importance of early recognition and management of sepsis and coagulopathy in the postpartum period to prevent irreversible complications such as SPG.
References
Macheka K., Masamha T., Mungani H., & Kumirayi L. Symmetrical peripheral gangrene: a rare clinical entity. Clinical Case Reports 2020;8(12):2913-2916. https://doi.org/10.1002/ccr3.3300
Sil A., Chakraborty U., Chandra A., & Biswas S.. COVID-19-associated symmetrical peripheral gangrene: a case series. Diabetes & Metabolic Syndrome Clinical Research & Reviews 2022;16(1):102356. https://doi.org/10.1016/j.dsx.2021.102356
Foead A., Mathialagan A., Varadarajan R., & Larvin M.. Management of symmetrical peripheral gangrene. Indian Journal of Critical Care Medicine 2018;22(12):870-874. https://doi.org/10.4103/ijccm.ijccm_379_18
Khan M., Shahid S., Zafar A., Khan N., & Bhatty S.. Unusual initial presentation of primary antiphospholipid syndrome as postpartum symmetrical peripheral gangrene. Journal of Ayub Medical College Abbottabad 2022;34(1). https://doi.org/10.55519/jamc-01-8695
Wang Y., Tang C., Li Y., & Hu W. Puerperal septic shock complicated with symmetrical peripheral gangrene: a case report. Medicine 2024;103(13):e37571. https://doi.org/10.1097/md.0000000000037571
Priyanka S., Dasgupta D., Abdullah A., Ali N., Khatun H., & Billah S.. The gap between coverage and components of postnatal care, as well as factors associated with quality postnatal care, among home and facility births in Bangladesh. 2023. https://doi.org/10.20944/preprints202312.1122.v1
Ali H., Mahmood Q., Jalil A., & Fischer F. Women’s status and its association with home delivery: a cross-sectional study conducted in Khyber-Pakhtunkhwa, Pakistan. Maternal and Child Health Journal 2022;26(6):1283-1291. https://doi.org/10.1007/s10995-021-03294-1
Batool W., Naveed S., Khan S., & Ahmed S.. Postpartum septic shock presenting as symmetrical peripheral gangrene: a rare entity. Pakistan Journal of Medical Sciences 2023;39(3). https://doi.org/10.12669/pjms.39.3.7277
Basnet S., Rajagopalan P., Dhital R., & Qureshi A. Symmetrical peripheral gangrene associated with low output cardiac failure. Medicina 2019;55(7):383. https://doi.org/10.3390/medicina55070383
Nazir S., Nazir A., Iqbal M., Shahnawaz S., Malik S., & Ali S.. Frequency of maternal morbidity and mortality in women with primary postpartum hemorrhage. Pak-Euro Journal of Medical and Life Sciences 2021;4(4):353-358. https://doi.org/10.31580/pjmls.v4i4.2441
Hussain M., Sharma S., Synmon B., & Hynniewta Y.. Digital gangrene in spinal tuberculosis. Indian Journal of Case Reports 2020;6(8):471-473. https://doi.org/10.32677/ijcr.2020.v06.i08.017
Adamu K. and Muhammad A. Symmetrical peripheral gangrene resulting from application of henna: a rare clinical occurrence. Pyramid Journal of Medicine 2023;6(2). https://doi.org/10.4081/pjm.2023.326
Chen X., Shao G., Zhao S., & Li N.. Symmetrical peripheral gangrene after cardiac surgery: a case report and review of the literature. Medicine 2025;104(7):e41527. https://doi.org/10.1097/md.0000000000041527
Warkentin T. and Ning S.. Symmetrical peripheral gangrene in critical illness. Transfusion and Apheresis Science 2021;60(2):103094. https://doi.org/10.1016/j.transci.2021.103094
Balasundaran P., Manoharan H., Bhargava J., Arya V., & Natarajan G. A curious case of black limb in tuberculosis. Journal of Global Infectious Diseases 2023;16(1):36-38. https://doi.org/10.4103/jgid.jgid_94_23
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