An Unreported Etiology for Couvelaire Uterus

Abstract

Couvelaire uterus or Utero-placental apoplexy is described in the setting of a gravid uterus with extravasations of blood into the uterine musculature to the depth of the uterine serosa with rare cases documenting hemorrhage extending to the broad ligaments and ovaries. There are very few cases reported in academic journals secondary to the nature of the diagnosis which involves either pathology or direct visualization during laparotomy. Majority of the time, Couvelaire uterus is related to placental abruption compromising both mother and fetus.
Case report: The case we describe is an unreported etiology of Couvelaire uterus, in which the complication arose after a dilation and evacuation secondary to missed abortion at 13 weeks of gestation. The case was further complicated by hemodynamic instability and obstructive urinary retention which eventually resulted in a hysterectomy having to be performed.