Couvelaire uterus in the setting of hemolysis syndrome, hepatic dysfunction, and thrombocytopenia. Presentation of a case

Abstract

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.