Couvelaire uterus in the setting of hemolysis syndrome, hepatic dysfunction, and thrombocytopenia. Presentation of a case
DOI:
https://doi.org/10.62452/fgfa5g17Keywords:
Placental abruption, Couvelaire’s uterus, HELLPAbstract
Couvelaire's uterus, or uteroplacental apoplexy, an exceptional clinical condition in modern obstetrics consisting of hematic infiltration of the uterine myometrium due to the formation of a massive retroplacental hematoma that cannot find its way out into the vaginal cavity and constitutes one of the most Severe cases of placental abruption, defined as partial or complete separation of a normally inserted placenta prior to the onset of labor. It occurs in 0.5-2% of all births, and of these, 50% of cases are accompanied by hypertensive disorders of pregnancy, associated with high perinatal maternal morbidity and mortality. There are different risk factors associated with placental abruption, among which the following stand out: hypertensive disorders of pregnancy, which continue to be an important cause of maternal morbidity and mortality, mainly secondary to cerebral hemorrhages, perinatal mortality due to prematurity, growth restriction intrauterine (IUGR), and abruptio placentae. The etiology is not defined, and its diagnosis is fundamentally based on clinical manifestations. A case of a pregnant woman with a Couvelaire uterus in the context of a HELLP syndrome is presented, at the Teófilo Dávila hospital in the city of Machala, which presented with alterations in the laboratory tests, and was successfully treated in the hospital. aforementioned health home.
Downloads
References
Ananth, C. V., Keyes, K. M., Hamilton, A., Gissler, M., Wu, C., Liu, S., Luque Fernández, M. Á., Skjaerven, R., Williams, M. A., Tikkanen, M., & Cnattingius, S. (2015). An international contrast of rates of placental abruption: an age-period-cohort analysis. PloS one, 10(5).
Baghel, S., Rai, R., & Khumna, V. (2015). Couvelaire Uterus. A case report. Research Paper International. Journal of Science Research, 4(11).
Berghella, V., Bellussi, F., & Schoen, C. N. (2020). Evidence-based labor management: induction of labor (part 2). American Journal of Obstetrics & Gynecology MFM, 2(3).
Couvelaire, A. (1912). Deux nouvelles observations d'apoplexie utéro-placentaire (hémorragies rétro-placentaires avec infiltration sanguine de la paroi musculaire de l'utérus). G. Steinheil, éditeur.
Elizalde Valdés, V. M., Calderón Maldonado, A. E., García Rillo, A., & Diaz Flores, M.(2015). Abruptio placentae: morbimortalidad y resultados perinatales. Universidad Autónoma del Estado de México.
Ghelfi, A. M., Garavelli, F., Passarino, F. A., Diodati, S., Calcaterra, M. G., Hails, E. A., Kilstein, J. G., Galíndez, J. O., Paciocco, M. A., Lassus, M. N., & Lassus, M. N. (2020). Síndrome HELLP: características clínicas, analíticas y evolutivas observadas en dos años de experiencia. Hipertensión y riesgo vascular, 37(4), 152-161.
Habek, D., Selthofer, R., & Kulaš, T. (2008). Uteroplacental apoplexy (Couvelaire syndrome). Wiener klinische Wochenschrift, 3(120), 88-88.
Lastra, M. A., & Fernández, G. M. (2020). Síndrome HELLP: controversias y pronóstico. Hipertensión y riesgo vascular, 37(4), 147-151.
Lee, Y. J., Calvert, K., & Jape, K. (2022). Couvelaire uterus resulting in haemoperitoneum. Journal of Surgical Case Reports, 2022(1).
Okafor, I. I., & Ugwu, E. O. (2015). Cesarean Delivery for a Life‑threatening Preterm Placental Abruption. Annals of Medical and Health Sciences Research, 5(6), 466-468.
Rai, S., & Singh, R. (2012). Couvelaire Uterus with Coagulopathy. A Rare Case Report. IJSR, 3(4), 364-365.
Roztocka, A., Ropacka-Lesiak, M., & Breborowicz, G. H. (2014). Preeclamptic pregnancy complicated by huge retroplacental hematoma and Couvelaire uterus. A case report. Archives of Perinatal Medicine, 20(4), 217-223.
Sibai, B. M., & Lindor, K. D. (2019). HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets). https://www.medilib.ir/uptodate/show/6778
Sylvester, H. C., & Stringer, M. (2017). Placental abruption leading to hysterectomy. Case Reports. BMJ Journal, 2017.
Zapata Díaz, B. M., & Ramírez Cabrera, J. O. (2020). Diagnóstico y manejo oportunos del síndrome HELLP. Revista Peruana de Ginecología y Obstetricia, 66(1), 57-65.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 María Isabel Macharé-Torres, Abel Agustín Estrada-Paneque, Juan Miguel Macharé-Torres (Autor/a)

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish in Revista Metropolitana de Ciencias Aplicadas (REMCA), agree to the following terms:
1. Copyright
Authors retain unrestricted copyright to their work. Authors grant the journal the right of first publication. To this end, they assign the journal non-exclusive exploitation rights (reproduction, distribution, public communication, and transformation). Authors may enter into additional agreements for the non-exclusive distribution of the version of the work published in the journal, provided that acknowledgment of its initial publication in this journal is given.
© The authors.
2. License
The articles are published in the journal under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License (CC BY-NC-SA 4.0). The terms can be found at: https://creativecommons.org/licenses/by-nc-sa/4.0/deed.en
This license allows:
- Sharing: Copying and redistributing the material in any medium or format.
- Adapting: Remixing, transforming, and building upon the material.
Under the following terms:
- Attribution: You must give appropriate credit, provide a link to the license, and indicate if any changes were made. You may do this in any reasonable manner, but not in any way that suggests the licensor endorses or sponsors your use.
- NonCommercial: You may not use the material for commercial purposes.
- ShareAlike: If you remix, transform, or build upon the material, you must distribute your creation under the same license as the original work.
There are no additional restrictions. You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.