Table 1. Potentially life-threatening diseases: symptoms and incidences.

Disease	Symptoms	Incidence
Delayed uterine atony(> 24 h postpartum)	Signs of poor uterine involution (uterine subinvolution): Increased uterine height (abdominal palpation), soft-doughy uterus, pain at the uterine border, possible subfebrile temperature, frontal headache, intermittent, persistent, possibly increasing bleeding Also additional severe bleeding, possibly symptoms of shock	Atonic bleeding (postpartum overall): 2.5%; 95% CI: [2.32; 2.62] (36) Delayed uterine atony (> 24 h postpartum): 0.2–2.5% (industrialized countries) (e93– e96)
Endomyometritis(chorioamnionitis and sepsis)	Fever, tachycardia, lower abdominal pain, relatively soft uterus that is painful on palpation, foul-smelling lochia, general feeling of being unwell, increased leukocytes (e29)	Chorionamnionitis 3.9% (8) Endomyometritis 1.6–1.9% (8, e97) Sepsis 0.05% (8)
Group A streptococcal sepsis	Acute disease course, usually within the first 48 h postpartum: high fever (in 73%), diffuse abdominal pain, putrid vaginal discharge, uterine tenderness, fever, chills, increased leukocytes, thrombocytopenia, hypotension (15)	6/100,000 Births (14)
Pre-eclampsia (modified from [4])	Blood pressure > 140/90 mm Hg Headache, photopsia/impaired vision, upper abdominal pain, nausea/vomiting, general malaise, weight gain Impairment to: kidneys, liver, CNS, hematological or respiratory system, IUGR or placental insufficiency	Hypertensive disorders (overall) 5–10% (e98) Pre-eclampsia ca. 4.6% Eclampsia ca. 1.4% (e97) Of which: Eclampsia 11–44% HELLP 7–30% (e100, e101) are postpartum (in relation to eclampsia/HELLP overall)
Eclampsia	Additional tonic-clonic seizures
HELLP syndrome	Upper abdominal pain, nausea, vomiting, hemolysis, elevated liver enzymes, thrombocytopenia
Thrombosis/embolism	As in outside of pregnancy/puerperium Cave: misclassification as physiological symptoms of the puerperium	Thrombosis 0.05–0.3% (23, 24) Embolism 0.08/1000 births (postpartum) (27) and 0.14/1000 (28) to 0.45/1000 (pre- and postpartum) (31) Pulmonary embolism 60.5 (28) to 61.3% postpartum (31)
Sheehan’s syndrome	Hypopituitarism: (reduced lactation, amenorrhea, genital and axillary hair loss, asthenia and weakness, premature skin aging, dry skin, and hypopigmentation)	See Table 2

IUGR, intrauterine growth restriction; CNS, central nervous system; 95% CI, 95% confidence interval