Puerperal complications: pathophysiological mechanisms and main imaging findings

Puerperium is the period during which the physiological changes that have taken place during pregnancy revert and the uterus involutes until it reaches its normal size. This is a period of intense systemic changes, and diagnosing complications in this period is a challenge for both gynecologists and radiologists. This paper reviews the complications that can occur during puerperium, classifying them according to the pathophysiological mechanisms involved: the prothrombotic state, hemodynamic and hormonal changes, rapid uterine growth, changes associated with endothelial damage (preeclampsia, eclampsia, and HELLP syndrome), and postoperative complications in patients undergoing cesarean sections. Puerperal complications represent a diagnostic challenge. Understanding the pathophysiological mechanisms underlying these complications is fundamental for choosing the most appropriate imaging technique to ensure the correct diagnosis in each case.