Couvelaire uterus

Couvelaire uterus
Couvelaire uterus
Classification and external resources
ICD-10 O45.8
ICD-9 641.2

Couvelaire uterus (also known as uteroplacental apoplexy)[1] is a life threatening condition in which loosening of the placenta (abruptio placentae) causes bleeding that penetrates into the uterine myometrium forcing its way into the peritoneal cavity.


Symptoms and signs

Patients can have pain secondary to uterine contractions, uterine tetany or localized uterine tenderness. Signs can also be due to abruptio placentae including uterine hypertonus, fetal distress, fetal death, and rarely, hypovolaemic shock (shock secondary to severe blood loss). The uterus may adopt a bluish/purplish, mottled appearance due to extravasation of blood into uterine muscle.


"Couvelaire uterus" is a phenomenon wherein the retroplacental blood may penetrate through the thickness of the wall of the uterus into the peritoneal cavity. This may occur after abruptio placentae. The hemorrhage that gets into the decidua basalis ultimately splits the decidua, and the haematoma may remain within the decidua or may extravasate into the myometrium (the muscular wall of the uterus). The myometrium becomes weakened and may rupture due to the increase in intrauterine pressure associated with uterine contractions. This may lead to a life-threatening obstetrical emergency.


The occurrence of couvelaire uterus can be prevented by prevention of abruptio placentae. This include proper management of hypertensive states of pregnancy; treatment of maternal diseases like diabetes mellitus, and other collagen disease complicating pregnancy; prevention of trauma during pregnancy; mothers should also avoid smoking or consumption of alcohol during pregnancy.


The uterus should be evacuated and contractions should be stimulated using intravenous oxytocin; hysterectomy (the removal of the uterus) may be needed in some cases.


The baby may be compromised if there is prolonged delivery because of the non-contractile uterus; severe bleeding may cause hypovolemic shock in the mother.


  1. ^ Hubbard JL, Hosmer SB (September 1997). "Couvelaire uterus". J Am Osteopath Assoc 97 (9): 536–7. PMID 9313351. 

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  • Uterus — The uterus (womb) is a hollow, pear shaped organ located in a woman s lower abdomen between the bladder and the rectum. The narrow, lower portion of the uterus is the cervix; the broader, upper part is the corpus. The corpus is made up of two… …   Medical dictionary

  • Couvelaire — Alexandre, French obstetrician, 1873–1948. See C. uterus …   Medical dictionary

  • Alexandre Couvelaire — (1873 1914) était un médecin français spécialisé en obstétrique. Biographie Son nom est associé à l utérus de Couvelaire, aussi nommé apoplexie utéro placentaire, qu il a décrite. Liens externes Photo de Alexandre Couvelaire sur… …   Wikipédia en Français

  • Placental abruption — | MeshID = D000037Placental abruption (Also known as abruptio placentae) is a complication of pregnancy, wherein the placental lining has separated from the uterus of the mother. It is the most common cause of late pregnancy bleeding. In humans,… …   Wikipedia

  • Apoplexy — A venerable term for a stroke, a cerebrovascular accident (CVA), often associated with loss of consciousness and paralysis of various parts of the body. The word apoplexy comes from the Greek apoplexia meaning a seizure, in the sense of being… …   Medical dictionary

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