Abstract

Zineb Bennani*, Meriem Kriouile, Houda Souradi, Mounia Yousfi and Samir Bargach

ABSTRACT

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 abruption occurring in 0.4 to 1% of pregnancies. Materials and methods: We report two cases of Couvelaire uterus on retroplacental hematoma, complicated by intrauterine fetal death. The first case is a 27-year-old patient, primigravida, referred for a typical clinical state of retroplacental hematoma associated with preeclampsia at 37 weeks of amenorrhea. The second case is a 38-year-old patient, hospitalized for an hemorrhagic shock within a context of retroplacental hematoma at 34 weeks of amenorrhea. Both cases were complicated by intrauterine fetal death and the diagnosis of Couvelaire uterus was made intraoperatively. The treatment was conservative for both cases, with no postoperative complications. Conclusion: The findings of Couvelaire uterus are infrequent. The diagnosis is made by visual inspection or biopsy and the recommended management is usually conservative. It can lead to maternal and fetal mortality, so we should be vigilant in monitoring antenatal bleeding and postpartum hemorrhage to reduce fetal and maternal morbidity and mortality.