Two women died and several others are battling kidney-related complications at Kota's New Medical College Hospital—a tragedy that underscores the importance of strict hygiene standards, timely monitoring, rapid response to warning signs and proper post-operative care in preventing maternal complications after C-sections, particularly post-surgical infections and sepsis.
At the said hospital, families continue their anxious wait as several women remain critical after undergoing cesarean deliveries. Some newborns, barely days old, are without their mothers’ care. Patients are reportedly undergoing dialysis and platelet transfusions, with a specialised medical team from Jaipur assisting in treatment.
Officials said seven women developed kidney failure after C-sections performed in the hospital’s gynecology ward on May 4. Among them, 28-year-old Payal died on May 5, followed by 20-year-old Jyoti on May 7. Another woman, Kiran, also reportedly developed kidney failure.
To understand the medical risks associated with cesarean deliveries, post-operative infections and the warning signs families should watch for, TNIE spoke to obstetricians and gynecologists, who stressed that while C-sections are often life-saving procedures, they remain major surgeries that require strict infection-control measures and close monitoring after delivery.
Why post-C-section infections can turn fatal rapidly
Explaining why infections after a C-section can turn life-threatening rapidly, Dr A Jaishree Gajaraj, Head of Obstetrics and Gynaecology at MGM Healthcare, Chennai, said, “Post-caesarean infections could escalate to become fatal very quickly due to the fact that a caesarean delivery is an extensive abdominal operation where the internal body organs, including blood vessels and the uterus, are directly exposed to possible bacterial infection.”
“The body’s natural defense mechanism against any form of infection becomes compromised during pregnancy and surgery, making it easy for any form of bacteria to gain entry into the bloodstream, uterus, surgical wound, or adjacent pelvic organs,” Dr Jaishree explained. “Failure to detect the infection may lead to rapid escalation and sepsis, where the body’s reaction to the infection has a multi organ failure.”
Dr Alpa Khakhar, Senior Consultant in Obstetrics & Gynecology and Reproductive Medicine at Apollo Women’s Hospitals, Chennai, said childbirth itself places enormous strain on the mother’s body. “After childbirth, a mother’s body is already under significant physiological stress, including blood loss, hormonal changes, and temporarily weakening immunity. If bacteria enter the surgical site, uterus, urinary tract, or bloodstream, it leads to a rapid spread of infection.”
According to Dr Alpa, women with repeat caesarean, diabetes, anaemia, obesity, prolonged labour are especially vulnerable, and if sepsis develops, it can result in low blood pressure and decreased oxygen supply to organs. In severe cases, “the body’s vital organs like kidneys, lungs, and heart may begin to fail.”
Why C-sections are medically more sensitive than vaginal deliveries
Doctors point out that although C-sections are generally safe in appropriate medical settings, they are still more medically sensitive and risk-prone than vaginal deliveries because they involve surgery through multiple layers of the abdomen and uterus.
“C-section deliveries are viewed as more delicate and risky compared to vaginal births due to its surgical nature, where there are many layers of the abdomen and uterus to go through in order to deliver the child,” Dr Jaishree said. This makes it more risky than the natural delivery method where one has to go through the natural passage of labour.
She added that women commonly experience “difficulty walking, breastfeeding, and engaging in everyday tasks during the early recovery stage.” Future pregnancies can also carry risks such as “rupture of the uterine wall, problems in the placenta like adherent placenta, or the surgical scar.”
Emergency C-sections, especially after prolonged labour or fetal distress, can be even more challenging. “C-sections done during emergency cases, following a long labor or fetal distress, can be particularly tricky since both the mother and the child may be at medical risk,” Dr Jaishree said, while adding that if a C-section procedure is well planned, then the chances of complications occurring are very less.
Dr Alpa similarly said, “Vaginal birth is a physiological procedure, whereas C-section is surgical. Every surgical procedure has its own risk due to factors like anaesthesia, blood loss, infection, and post-op recovery.”
Common complications after caesarean deliveries
Among the most common complications seen after caesarean deliveries are wound infections, urinary tract infections, pelvic infections, excessive bleeding, blood clots, anaesthetic complications and injuries to surrounding organs.
“Among the typical complications experienced after such operations, there are surgical wound infections, post-surgical excessive bleeding, infections of the urinary tract, formation of blood clots, difficulty in the healing of the wound, infections of the pelvis, anaesthetic reaction, as well as injuries to the uterus and other surrounding organs such as bladder and bowel,” Dr Jaishree explained.
She warned that post-operation infections remain a major complication since it begins as a local infection that can advance to sepsis because of delay in treatment.
According to Dr Jaishree, prolonged immobility after surgery can also cause clots in the legs, which can travel to the lungs, creating life-threatening risks. Some patients may suffer severe bleeding requiring blood transfusions or even additional surgery. Other complications include “chronic pelvic pain, adhesions, and difficulties with pregnancies in the future.”
Dr Alpa added that post-caesarean complications commonly include surgical wound infection, urinary tract infection, excessive bleeding, blood clots in the legs or lungs (pulmonary embolism), fever, and post-operative sepsis.”
“In most cases, infections following caesarean delivery are relatively mild and can be treated with the use of antibiotics. If not addressed on time, however, they might progress to cause infections in deeper tissues as well as in the bloodstream,” she said.
In extreme situations, patients may require intensive care, ventilation, re-operation, or even hysterectomy due to excessive bleeding.
Early warning signs families should never ignore
Doctors stressed that early detection is critical because sepsis symptoms can initially appear mild and non-specific.
“It is imperative that patients and their family members do not overlook any initial signs of infections following a cesarean delivery since sepsis can occur extremely rapidly,” Dr Jaishree said.
She listed warning signs including fever, particularly when coupled with chills, profuse sweating, general body weakness, excruciating pain around the abdomen area, excessive tenderness in the operated region, redness and swelling of the operated site, pus formation around the incision made for surgery, difficulty in breathing, dizziness, confusion, weakness, reduced urine output, altered bowel habits, and loose stools.
Other concerning symptoms include “frequent vomiting, inability to eat, painful sensation in the pelvis or unusual discharge from the vagina.”
Complications can become more severe in women with “diabetes, anemia, obesity or long-term labor,” she warned. Even if the symptoms appear to be mild initially, she said, it is important to medically evaluate the patients because delay in treatment can result in septic shock, multi-organ failure, and life-threatening complications.
Dr. Alpa also said that families should seek immediate medical attention if mothers develop “continued fever or chills, worsening abdominal pain, inflammation, swelling, or discharge of pus from the wound, foul-smelling vaginal discharge, difficulty breathing, less urine output, extreme weakness or confusion, fast heartbeat or low blood pressure.”
“One important concern is that sepsis may initially appear like a simple fever or weakness,” Dr Alpa said. “Delay in recognising these symptoms is one of the biggest reasons infections become dangerous."
Hospital protocols and infection-control measures
Doctors say hospitals play a critical role in preventing such infections through strict infection-control protocols and post-operative monitoring.
Dr Nandhini Elumalai, Senior Consultant in Obstetrics and Gynecology at SRM Prime Hospital, Chennai, said hospitals are expected to follow “highly specific” infection-control measures before, during and after surgery.
“The importance of pre-operation care in order to eliminate infections, which includes: patients' screening and qualification before surgery, sterilization procedures of surgical instruments, operating room disinfectors and also hand-washing behavior among medical staff,” she explained.
During surgery, hospitals must ensure “sterile gloves, drapes, a sterile operating gown, and a strict sterile operating environment.”
Nandhini said hospitals should strictly monitor:
OT sterilization protocols
Antibiotics before and after surgery
Hand hygiene and infection control
Monitoring fever, BP, pulse, bleeding, urine output
Early signs of sepsis or shock
ICU readiness in high-risk mothers
Avoiding unnecessary C-sections
How infections begin damaging organs like the kidneys
The doctors also explained how post-surgical infections eventually begin damaging organs such as the kidneys.
“A post-surgery infection tends to begin affecting organs such as the kidneys when the infection starts spreading into the bloodstream and triggers a severe inflammatory response; this condition is known as sepsis,” Dr Nandhini said.
In obstetric cases, “Puerperal sepsis can occur after childbirth, particularly when infections develop in the reproductive tract following delivery or cesarean section.”
“If not treated promptly, the infection may spread into the bloodstream and progress to sepsis, causing serious complications for the mother,” she warned.
Dr Nandhini explained that during sepsis, blood flow to the vital organs tends to decrease, leading to kidney injury and dysfunction. Prolonged inflammation damages tissues and affects oxygen supply, eventually resulting in “multiple organ failure.”
Dr Alpa added that once infection reaches the bloodstream and progresses to “sepsis or septic shock,” inflammation begins disrupting blood circulation across the body.
“Due to low blood pressure levels, multiple systems such as the kidneys, lungs, liver, and brain are impacted. Kidney gets impacted first as they depend on steady blood flow,” she said.
Patients can develop “acute kidney injury, decreased urine output, and accumulation of toxins in the body,” eventually leading to failure of multiple organs.
“Despite all efforts by medical professionals to save them in intensive care units with antibiotics, dialysis, ventilatory support, and vasopressors, recovery might still be difficult due to the systemic effects that take place in the body,” Dr Alpa said.