Parul Nigam
St. Jude’s Hospital, Jhansi, India
Title: A classic case of couvelaire uterus: Case report
Biography
Biography: Parul Nigam
Abstract
Couvelaire uterus also known as uteroplacental apoplexy is a very rare and life threatening condition in which premature separation of placenta causes bleeding that penetrates into the myometrium forcing its way into the peritoneal cavity. Its exact incidence is not known but is estimated to complicate about 5% of all cases of abruption. This paper reports a classic case of couvelaire uterus which we encountered some time back in our hospital. The patient was 24 yr. old primi at 35 weeks of pregnancy presenting at the middle of night with vaginal bleeding and loss of foetal movements. Her general condition was very low. She was severely anemic and hypertensive. Foetal heart sounds could not be traced. Patient was managed by an emergency caesarian section. The patient and her uterus could be saved but the baby was found dead and macerated. Placenta was already separated and retroplacental haemorrhage of about 1.5 liters was noted. This paper emphasizes the importance of antenatal screening and strict blood pressure monitoring in pregnancy. Nowadays new markers are available for early prediction of PIH and preeclampsia.