BACKGROUND

Couvelaire uterus or uteroplacental apoplexy is a blood infiltration of the uterine myometrium due to the formation of a massive retroplacental hematoma. Couvelaire uterus is one of the most severe complications in placental detachment occurring in 0.4 to 1% of pregnancies.

CLINIC CASE

26-year-old female patient, primigravida, with 37 weeks and six days given by her last menstruation day, from La Esperanza, Intibucá, Honduras. The patient presented amaurosis, high tension figures and extrahospitalary fetal death with maceration grade 1. Her mother refers the patient had seizures but she doesn’t know the data. In the physical examination the patient had a blood pressure of 130/100 mmhg, glasglow 11/15, fetal heart rate of 0 bpm, uterine fundus height of 34 cm, cervix dilation of 10 cm, presentation height +1, and cephalic presentation. Laboratory tests included qualitative proteinuria +++, leukocytosis with neutrophilic predominance and increased creatinine levels. Coagulation times were reported abnormal. The patient was unstable so she was received in cubicle of severes by a hypotonic uterus. An exploratory laparotomy was performed by which the results were an enlarged flaccid uterus with 90% of infiltration with predominance in the left side, a diagnosis compatible with Couvelaire Uterus.

CONCLUSION

The findings of Couvelaire Uterus are infrequent, so we must take into account this pathology because it can lead to maternal and fetal mortality.