Abstract
Renal cortical necrosis is the destruction of the cortical tissue resulting from renal arteriolar injury, leading to acute kidney injury. This rare condition typically manifests in neonates and pregnant or postpartum women when sepsis or pregnancy-related complications occur. Symptoms include macroscopic hematuria, flank pain, reduced urine output, fever, and the onset of uremic symptoms. We present a 38-year-old multiparous patient with no significant medical history, admitted for vaginal delivery at 37 weeks, complicated by pre-eclampsia, eclampsia, HELLP syndrome, retroplacental hematoma, and acute kidney injury requiring dialysis. She also experienced significant postpartum hemorrhage with hemodynamic instability, necessitating labile blood products and tranexamic acid administration.