Couvelaire uterus
Rare uterine condition from abruptio placentae with myometrial bleeding.
Couvelaire uterus, also termed uteroplacental apoplexy, is a rare and life-threatening condition. It arises when abruptio placentae causes bleeding that penetrates into the uterine myometrium and forces its way into the peritoneal cavity. The uterus becomes very tense and rigid as a result.
Did You Know?
- Patients can have pain secondary to uterine contractions, uterine tetany, or localized uterine tenderness.
- The uterus may adopt a bluish/purplish, mottled appearance due to extravasation of blood into uterine muscle.
- Prevention includes proper management of hypertensive states of pregnancy and avoidance of smoking or alcohol during pregnancy.
Pathophysiology
In Couvelaire uterus, retroplacental blood may penetrate through the full thickness of the uterine wall into the peritoneal cavity after abruptio placentae. Hemorrhage entering the decidua basalis splits the decidua, and the hematoma may remain within the decidua or extravasate into the myometrium. The weakened myometrium may rupture due to increased intrauterine pressure from contractions, creating a life-threatening obstetric emergency that requires urgent delivery of the fetus.
More in Pathology of Pregnancy, Childbirth and the Puerperium
Spotted an error? Know more?
Reader corrections go straight into our review queue. Suggest an edit · How this site is sourced