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      Report of a Complicated Case of Couvelaire Uterus

      case-report

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          Abstract

          Couvelaire uterus (CU) is a rare complication in the life-threatening placental abruption (PA) that consists of a state of blood infiltration of the uterine myometrium and serosa. The incidence is around 1% and the treatment of choice is obstetric hysterectomy, however, in some cases, close monitoring and timely decision-making can prevent hysterectomy. Herein, we present a rare and serious case of CU with uterus preservation in a young multiparous with a high-risk pregnancy.

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          Placental abruption: epidemiology, risk factors and consequences.

          Minna Tikkanen (2011)
          Placental abruption, classically defined as a premature separation of the placenta before delivery, is one of the leading causes of vaginal bleeding in the second half of pregnancy. Approximately 0.4-1% of pregnancies are complicated by placental abruption. The prevalence is lower in the Nordic countries (0.38-0.51%) compared with the USA (0.6-1.0%). Placental abruption is also one of the most important causes of maternal morbidity and perinatal mortality. Maternal risks include obstetric hemorrhage, need for blood transfusions, emergency hysterectomy, disseminated intravascular coagulopathy and renal failure. Maternal death is rare but seven times higher than the overall maternal mortality rate. Perinatal consequences include low birthweight, preterm delivery, asphyxia, stillbirth and perinatal death. In developed countries, approximately 10% of all preterm births and 10-20% of all perinatal deaths are caused by placental abruption. In many countries, the rate of placental abruption has been increasing. Although several risk factors are known, the etiopathogenesis of placental abruption is multifactorial and not well understood. © 2010 The Author Acta Obstetricia et Gynecologica Scandinavica© 2010 Nordic Federation of Societies of Obstetrics and Gynecology.
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            The environmental risk factors prior to conception associated with placental abruption: an umbrella review

            Ensiyeh Jenabi, Zohreh Salimi, Erfan Ayubi … (2022)
            Background The present umbrella review evaluated risk factors prior to conception associated with placental abruption based on meta-analyses and systematic reviews. Methods We searched PubMed, Scopus, and Web of Science until June 25, 2021. All meta-analyses that had focused on assessing the risk factors associated with placental abruption were included. We calculated summary effect estimates, 95% CI, heterogeneity I 2, 95% prediction interval, small-study effects, excess significance biases, and sensitive analysis. The quality of the meta-analyses was evaluated with A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Results There was no risk factor in the present umbrella review with the high level of evidence (class I or II). Eight risk factors including maternal asthma (RR 1.29 95% CI 1.14, 1.47), prior cesarean section (RR 1.38, 95% CI 1.35–1.42), cocaine using (RR 4.55, 95% CI 1.78–6.50), endometriosis (OR 1.40, 95% CI 1.12–1.76), chronic hypertension (OR 3.13, 95% CI 2.04–4.80), advanced maternal age (OR 1.44, 95% CI 1.35–1.54), maternal smoking (OR 1.80, 95% CI 1.75–1.85) (RR 1.65, 95% CI 1.51–1.80), and use of assisted reproductive techniques (ART) (OR 1.87, 95% CI 1.70–2.06) were graded as suggestive evidence (class III). The other four risk factors including pre-pregnancy underweight (OR 1.38, 95% CI 1.12–1.70), preeclampsia (OR 1.73, 95% CI 1.47–2.04), uterine leiomyoma (OR 2.63, 95% CI 1.38–3.88), and marijuana use (OR 1.78, 95% CI 1.32–2.40) were graded as risk factors with weak evidence (class IV). Conclusion Maternal asthma, prior cesarean section, cocaine use, endometriosis, chronic hypertension, advanced maternal age, maternal smoking, and use of ART, pre-pregnancy underweight, preeclampsia, uterine leiomyoma, and marijuana use were risk factors associated with placental abruption. Although factors associated with placental abruption have been investigated, the current meta-analytic associations cannot disentangle the complex etiology of placental abruption mainly due to their low quality of evidence. Supplementary Information The online version contains supplementary material available at 10.1186/s13643-022-01915-6.
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              Beckmann and Ling’s obstetrics and gynecology

              R Casanova, R. CASANOVA, A. Chuang … (2018)
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                Author and article information

                Contributors
                Amir Mohammad Salehi:
                ORCID: https://orcid.org/0000-0002-1724-6432
                Journal
                Journal ID (nlm-ta): Case Rep Med
                Journal ID (iso-abbrev): Case Rep Med
                Journal ID (publisher-id): CRIM
                Title: Case Reports in Medicine
                Publisher: Hindawi
                ISSN (Print): 1687-9627
                ISSN (Electronic): 1687-9635
                Publication date Collection: 2023
                Publication date (Electronic): 27 June 2023
                Volume: 2023
                Electronic Location Identifier: 6668328
                Affiliations
                1Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, Hamadan University of Medical Sciences, Hamadan, Iran
                2Student Research Committee, Hamadan University of Medical Sciences, School of Medicine, Hamadan, Iran
                Author notes

                Academic Editor: Ron Rabinowitz

                Author information
                https://orcid.org/0000-0003-4402-914X
                https://orcid.org/0000-0003-4195-3177
                https://orcid.org/0000-0002-1724-6432
                https://orcid.org/0009-0005-3236-1331
                Article
                DOI: 10.1155/2023/6668328
                PMC ID: 10319456
                PubMed ID: 37408702
                SO-VID: 5d5494a9-f0a8-4f7d-9c61-8047875a91e2
                Copyright statement: Copyright © 2023 Hamideh Parsapour et al.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 February 2023
                Date revision received : 13 April 2023
                Date accepted : 23 June 2023
                Categories
                Subject: Case Report

                Data availability:

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