Symmetrical peripheral gangrene (SPG) is an uncommon but devastating complication in critically ill patients with a high mortality. It was first described by Hutchison in 1891(1). Despite the frequent use of ergots and settings of sepsis, we rarely encounter SPG in pregnant women. Whether it is because of physiological changes in the peripheral vascular system during pregnancy (increased plasma volume, decreased plasma osmolality and decreased peripheral resistance) that actually prevents severe vasospasm is not fully understood?

Here we describe a case where SPG occurred in a postpartum patient with Septic shock with acute renal failure with cardiomyopathy (PPCM).