Imaging and Pitfalls of Early Postpartum Complications after Vaginal and Cesarean Section

The postpartum period is associated with a wide spectrum of potential complications that may lead to significant maternal morbidity and mortality if not promptly diagnosed and treated. Clinical presentation is frequently nonspecific - including symptoms such as pelvic pain, fever, and vaginal bleeding - rendering imaging indispensable for differentiating normal postpartum changes from pathologic conditions. Radiologists should be familiar with the expected postpartum imaging appearance of the uterus as well as the imaging findings of common and uncommon complications. This review provides an imaging-centered overview of postpartum complications after vaginal and cesarean delivery, including endometritis, retained products of conception, postpartum hemorrhage, uterine rupture, uterine dehiscence, along with key extrauterine complications. We discuss the strengths and limitations of ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) in the evaluation of these conditions. Key imaging features and diagnostic pitfalls across modalities are highlighted to aid radiologists in accurate interpretation. This review aims to improve diagnostic confidence and ultimately enhance patient outcomes in the postpartum population.