Pregnancy and Its Diseases 264. Placenta Previa and Abruptio Placentae 265

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Pregnancy and Its Diseases 264. Placenta Previa and Abruptio Placentae 265. Couvelaire Uterus, Rupture of the Uterus, and Maternal Pulmonary Embolism 266. Ectopic Pregnancy: Tubal Pregnancy 267. Abortion 268. Syphilis 269. Puerperal Infection 270. Intrauterine Neoplasms 271. Erythroblastosis Fetalis 272. Acute Toxemia of Pregnancy: Symptomatology of Preeclampsia and Eclampsia 273. Acute Toxemia of Pregnancy: Visceral Lesions in Preeclampsia and Eclampsia 274. Acute Toxemia of Pregnancy: Placental Lesions in Preeclampsia nad Eclampsia and Infracts Pathology of the Mammary Gland 275. Painful Engorgement and Puerperal Mastitis 276. Fibrocystic Disease: Early Changes 277. Fibrocystic Disease: Cystic Changes 278. Fibrocystic Disease: Adenosis 279. Benign Fibroadenoma and Intracystic Papilloma 280. Giant Myxoma and Sarcoma 281. Infiltrating Carcinoma 282. Fulminant Carcinoma 283. Circumscribed Forms of Adenocarcinoma 284. Paget Disease of the Nipple INTEGUMENTARY SYSTEM Acute Dermatitis 285. Urticaria and Acute Eczematous Dermatitis 286. Erythema Multiforme Chronic Dermatitis 287. Lichen Planus and Psoriasis Vesicular and Bullous Dermatoses 288. Dermatitis Herpetiformis and Pemphigus Vulgaris Infectious Diseases 289. Impetigo, Cellulitis, and Erysipeals 290. Herpes Simplex and Varicella Zoster 291. Miscellaneous Viral Skin Infections 292. Dermal Candidiasis 293. Lyme Disease Hyperplasia and Benign Tumors 294. Keratoses 295. Nevi Malignant Tumors 296. Basal Cell Carcinoma 297. Squamous Cell Carcinoma 298. Malignant Lymphomas 299. Malignant Melanoma HEMATOPOIETIC AND LYMPHATIC TISSUES Red Blood Cell Disorders 300. Acquired Anemias 301. Hereditary Anemias 302. Anemias of Deficient Hemopoiesis 303. Polycythemia Vera 304. Malaria White Blood Cell Disorders ( Nonlymphatic) 305. Hematopoietic Hypoplasia 306. Myelodysplastic Syndrome 307. Osteomylofibrosis 308. Chronic Myelogenous Leukemia 309. Primary Thrombocythemia 310. Acute Myelogenous Leukemia 311. AML Subtypes M0, M1, and M2 312. AML Subtypes M3 313. AML Subtypes M4 and M5 314. AML Subtypes M6 and M7 Nonneoplastic Lymphatic Disorders 315. Lymphatic Hyperplasia 316. Autoimmune Diseases 317. Suppurative Inflammation 318. Granulomatous Inflammation 319. Viral Infections 320. Immune Deficiency Disorders 321. Graft-Versus-Host Reaction Neoplastic Lymphatic Disorders 322. Hodgkin Disease 323. Non-Hodgkin Lymphomas, Microscopic View 324. Lymphocytic Leukemias 325. Multiple Myeloma and Waldenstrom Disease.

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Couvelaire Uterus Manju Rathi,1 Sunil Kumar Rathi,2 Manju Purohit,3,4 Ashish Pathak2,5
BMJ Case Reports: first published as 10.1136/bcr-2014-204211 on 31 March 2014. Downloaded from Images in… Couvelaire uterus Manju Rathi,1 Sunil Kumar Rathi,2 Manju Purohit,3,4 Ashish Pathak2,5 1Department of Obstetrics and DESCRIPTION packed cells during the surgery and two more Gynecology, RD Gardi Medical A 23-year-old primiparous woman with 37 weeks transfusions of 200 mL of packed cells were given College, Ujjain, Madhya Pradesh, India of amenorrhoea was admitted to the Obstetric in the postoperative period. She was given cefazolin 2Department of Peadiatrics, RD ward with symptoms of severe abdominal pain and 1 gm every 8 hours for 5 days in view of leucocyt- Gardi Medical College, Ujjain, non-progression of labour past 20 h. The patient osis. The rest of her postoperative stay was normal. Madhya Pradesh, India 1 ﬁ 3 was registered for antenatal care at a peripheral Couvelaire rst described the entity in 1911. It Department of Pathology, RD health centre (PHC). She had two previous ante- is a rare non-fatal complication of severe abrup- Gardi Medical College, Ujjain, 23 Madhya Pradesh, India natal visits at the PHC. Her last visit was 15 days tion. It is estimated to complicate 5% of all cases 2 4Department of Public Health prior to admission, during which her blood pres- of abruption. The entity is infrequently reported Sciences, Global Health sure was found to be normal. In her second trimes- and the incidence is difﬁcult to estimate because (IHCAR), Stockholm, Sweden 5 ter visit, her blood group was B positive, the diagnosis is made by direct visualisation or Department of Women and 23 Children’s Health, International haemoglobin was found to be 8.5 g/100 mL, urine biopsy.
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Couvelaire Uterus ISSN: 2394-0026 (P) ISSN: 2394-0034 (O) Case Report
Couvelaire uterus ISSN: 2394-0026 (P) ISSN: 2394-0034 (O) Case Report Couvelaire uterus - A case report Mahendra G 1*, Ravindra S. Pukale 2, Vijayalakshmi S 3, Priya 4 1Assistant Professor, 2Associate professor, 3Professor and Head, 4Junior Resident Department of Obstetrics and Gynecology , Adichunchanagiri Institute of Medical S ciences, B.G. Nagara, India *Corresponding author email: [email protected] How to cite this article: Mahendra G , Ravindra S. Pukale, Vijayalakshmi S , Priya . Couvelaire uterus - A case report. IAIM, 2015; 2(3): 142 -145. Available online at www.iaimjournal.com Received on: 03-01-2015 Accepted on: 16-01-2015 Abstract “Couvelaire uterus” or “Utero-placental apoplexy” is a rare complication of severe forms of placental abruption. It occurs when vascular damage within the placenta causes hemorrhage that progresses to and infiltrates the wall of the uterus . We presented here rare case of 23 years old f emale with Couvelaire uterus. Key words Couvelaire uterus, Utero-placental apoplexy, Placental abruption. Introduction pregnancy induced hypertension ( PIH) in “Couvelaire uterus” or “Utero -placental previous pregnancy. Her personal and family apoplexy” is a rare complication of severe forms history was not significant. of placen tal abruption. It occurs when vascular damage within the placenta causes hemorrhage General examination • that progresses to and infiltrates the wall of the Pallor +++ uterus [1]. It is a syndrome that can only be • BP - 116/80 mm Hg in t he supine left diagnosed by direct visualization or biopsy (or lateral position both). For this reason, its occurrence is perhaps • Pulse rate - 108/min underreported and underestimated in the literature [2].
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PREGNANCY in a RUDIMENTARY HORN of a UTERUS DIDELPHYS with Concealed Accidental Haemorrhage
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Early Accreta and Uterine Rupture in the Second Trimester
Open Access Case Report DOI: 10.7759/cureus.2904 Early Accreta and Uterine Rupture in the Second Trimester Joshua A. Ronen 1 , Krystal Castaneda 2 , Sara Y. Sadre 3 1. Internal Medicine, Texas Tech University Health Sciences Center of the Permian Basin, Odessa, USA 2. MS3/Ross University School of Medicine, California Hospital Medical Center, Los Angeles, USA 3. MS4/Ross University School of Medicine, California Hospital Medical Center, Los Angeles, USA Corresponding author: Joshua A. Ronen, [email protected] Abstract The differential diagnosis of third trimester bleeding can range from placenta abruptia to placenta previa to uterine rupture and the placenta accreta spectrum (PAS). However, patients with risk factors such as multiple cesarean sections (c-sections), advanced maternal age (AMA), grand multiparity, and single-layer uterine closure are at greater risk of developing these complications earlier than we would traditionally expect. This case recounts a 38-year-old gravida 6 preterm 3 term 1 abortus 1 live 4 (G6P3114) at 23 weeks and five days gestational age (GA) with a past medical history of preterm pregnancy, pre-eclampsia, chronic abruptia, three previous c-sections, and low-lying placenta who presented to the emergency department (ED) with vaginal bleeding. Initial workup revealed placenta accreta and possible percreta. The patient was placed on intramuscular (IM) corticosteroids in anticipation of preterm delivery. As soon as the patient was stable, she was discharged home. She presented to a different hospital the next day with the same complaints. Imaging was consistent with accreta and her presentation with abruption. During the hospital stay, the patient went into threatened preterm labor (PTL).
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Placental Abruption: Management
Official reprint from UpToDate® www.uptodate.com ©2017 UpToDate® Placental abruption: Management Authors: Yinka Oyelese, MD, Cande V Ananth, PhD, MPH Section Editor: Charles J Lockwood, MD, MHCM Deputy Editor: Vanessa A Barss, MD, FACOG All topics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: May 2017. | This topic last updated: Mar 02, 2016. INTRODUCTION — This topic will discuss the management of pregnancies complicated by placental abruption. The clinical features, diagnosis, and potential consequences of abruption are reviewed separately. (See "Placental abruption: Clinical features and diagnosis".) INITIAL APPROACH FOR ALL PATIENTS — Pregnant women with symptoms of abruption should be evaluated promptly on a labor and delivery unit to establish the diagnosis, assess maternal and fetal status, and initiate appropriate management. Patients who have an apparently small abruption and are initially stable may deteriorate rapidly if placental separation progresses. They may also deteriorate from sequelae of potential comorbidities, such as preeclampsia, cocaine use, or trauma. The following actions are reasonable initial interventions: ● Initiate continuous fetal heart rate monitoring, since the fetus is at risk of becoming hypoxemic and developing acidosis. ● Secure intravenous access. Place one wide-bore intravenous line; two if the patient presents with signs of moderate or severe abruption, such as moderate to heavy bleeding, hypotension, tachysystole, uterine hypertonicity and tenderness, coagulopathy, or an abnormal fetal heart rate. Administer crystalloid, preferably Lactated Ringer's, to maintain urine output above 30 mL/hour. ● Closely monitor the mother's hemodynamic status (heart rate, blood pressure, urine output, blood loss). Assessment of multiple parameters is important because normal blood pressure may mask hypovolemia if the mother has chronic hypertension or pregnancy-associated hypertension, which are risk factors for abruption.
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An Unusual Case of Ruptured Uterus
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A Clinical Study of Maternal and Fetal Outcome in Abruptio Placenta - Couvelaire Uterus a Preventable Obstetric Catastrophe Vijayasree M
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Case Report Chronic Abruption in Early
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13 Obstetrics
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Couvelaire Uterus Cell Count, 23.7Xl03 (6.5 to 11.0XI03); Hemoglobin, 11.7 Mg/Dl (12.7 to 14.7 JAMES L
IUFD workup, as well as laboratory stud + Case repotts continued ies for preeclampsia, was ordered. Laboratory studies showed the fol lowing values (reference laboratory nor mal range in parentheses): white blood Couvelaire uterus cell count, 23.7xl03 (6.5 to 11.0XI03); hemoglobin, 11.7 mg/dL (12.7 to 14.7 JAMES L. HUBBARD, DO mg/dL); hematocrit, 32.2% (37.9% to STEPHAN B. HOSMER, DO 43.9%); and platelets, only 55 XI03 (140 to 450 X 103). The prothrombin time was 15.7 seconds (11 to 13 seconds); partial Uteroplacental apoplexy is a rare but nonfatal complication of severe forms of pla tlu'omboplastin time, 30.8 seconds (20 to cental abruption. It occurs when vascular damage within the placenta causes 30 seconds); fibrinogen, 40 mg/dL (170 hemorrhaging that progresses to and infiltrates the wall of the uterus. It is a syn to 410 mg/dL); and fibrin split products, drome that can only be diagnosed by direct visualization or biopsy (or both). For 640 mg/dL «10 mg/dL). Results of liver this reason, its occurrence is perhaps underreported and underestimated in the lit function tests were within normal limits erature. The subject of this report is a 24-year-old pregnant woman who had a except for the lactate dehydrogenase level placental abruption and in whom classic uteroplacental apoplexy was diagnosed of 3428 UIL (313 to 618 UIL) and the at the time of her cesarean section. uric acid level of 8.2 mg/dL (2.5 to 6.2 (Key words: Couvelaire uterus, uteroplacental apoplexy, placental abruption, mg/dL).
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Couvelaire Uterus: a Case Report
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