Macrophagic Activation Syndrome Complicating Delivery in a Patient with a Triply Scarred Uterus: Case Report

Macrophage Activation Syndrome (MAS), also known as hemophagocytic syndrome, is a rare and severe condition characterized by excessive activation of macrophages in the bone marrow and lymphoid organs, leading to hemophagocytosis and hypercytokinemia. MAS can be primary, primarily affecting children with hereditary immune disorders, or secondary, triggered by infections, malignancies, or autoimmune diseases. We report a case of secondary MAS that developed post-delivery in a 40-year-old multiparous woman with a triply scarred uterus. Complications, including ventilator-associated pneumonia caused by Stenotrophomonas maltophilia and a urinary tract infection caused by Klebsiella pneumoniae, exacerbated her condition. Histological confirmation of hemophagocytosis established the diagnosis of MAS. Despite intensive treatment, the patient ultimately succumbed to sepsis. This case underscores the severity of MAS in obstetric settings, often triggered by infections, and highlights the importance of early diagnosis and management to improve prognosis.