Couvelaire Uterus

This case report describes a 29 year old primigravida presenting at 33 weeks’ gestation with concealed placental abruption, diagnosed via transabdominal ultrasonography showing retroplacental hemorrhage (Panel A). Emergency cesarean section revealed a Couvelaire uterus bruising from blood extravasation into the myometrium (Panel B). The newborn had favorable Apgar scores (8 and 9 at 1/5 minutes), but the uterus was atonic post delivery, requiring uterotonics (carbetocin, oxytocin, misoprostol, tranexamic acid). The mother recovered without complications, while the preterm infant required hospitalization. The case underscores the importance of prompt diagnosis in concealed abruption to prevent fetal hypoxia or death.

This case report describes a 29 year old primigravida presenting at 33 weeks’ gestation with concealed placental abruption, diagnosed via transabdominal ultrasonography showing retroplacental hemorrhage (Panel A). Emergency cesarean section revealed a Couvelaire uterus bruising from blood extravasation into the myometrium (Panel B). The newborn had favorable Apgar scores (8 and 9 at 1/5 minutes), but the uterus was atonic post delivery, requiring uterotonics (carbetocin, oxytocin, misoprostol, tranexamic acid). The mother recovered without complications, while the preterm infant required hospitalization. The case underscores the importance of prompt diagnosis in concealed abruption to prevent fetal hypoxia or death.