Abstract: Postpartum clinical deterioration can occasionally mask uncommon but serious underlying conditions. We present the case of a 29?year?old multiparous woman who developed abdominal distension, fever and worsening clinical status following an uneventful vaginal delivery. Initially managed as puerperal sepsis, her atypical course prompted further evaluation, ultimately revealing a bladder rent requiring surgical intervention. Prompt surgical repair led to complete recovery. Since its manifestations often mimic puerperal sepsis, recognition is frequently delayed, increasing the risk of morbidity. This report highlights key clinical indicators, the diagnostic utility of ascitic?fluid biochemical analysis (including ascitic creatinine values), the importance of timely surgical decision making and need for a high index of suspicion for visceral injury in preventing morbidity in cases of atypical postpartum decline [1-10].
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