COUVELAIRE UTERUS: A CASE REPORT

Abstract

PREMATURE PLACENTA DETACHMENT (DPP) CONSISTS OF THE SEPARATION OF THE PLACENTA THAT SHOULD BE IMPLANTED IN THE BODY OF THE UTERUS, BEFORE DELIVERY, AND MAY INCUR FETAL MORTALITY, PREMATURITY AND MATERNAL MORBIDITY. THE DPP MAY BE ASYMPTOMATIC, VAGINAL BLEEDING AND ABDOMINAL PAIN, OR SYMPTOMATIC. AMONG THE RISK FACTORS THAT LEAD TO PPD IS HELLP SYNDROME (ELEVATION OF LIVER ENZYMES AND THROMBOCYTOPENIA). HEMOCYTES AND SERUM FROM A RETROPLACENTAL CLOT CAN DISSOCIATE MYOFIBRILS AS THEY TRAVEL THROUGH THE MYOMETRIUM, RESULTING IN THE COUVELAIRE UTERUS. THUS, THE AIM OF THIS STUDY IS TO FIND INDICATIONS THAT MAY INDICATE, EVEN IN ASYMPTOMATIC PATIENTS, THE PRESENCE OF PPD AND COUVELAIRE'S UTERUS, IN ORDER TO AVOID THE UNFAVORABLE EVOLUTION OF THESE CASES. THE CASE IS RELATED TO THE MCLC PATIENT, 34 YEARS OLD, QUADRIGESTA WITH GESTATION OF 35 WEEKS AND 2 DAYS AND PRE-NATAL AT USUAL RISK PRESENTING WEAKNESS, DIFFICULTY TO AMBULATE AND ABSENCE OF FETAL MOVEMENTS FOR MORE THAN 2 HOURS. REGULAR STATE, BCF INAUDIBLE, CLOSED CERVIX AND NO BLEEDING AT VAGINAL TOUCH. THE DIAGNOSIS WAS NOT MADE PREVIOUSLY BECAUSE OF THE ABSENCE OF CLASSIC SIGNS SUCH AS ABDOMINAL PAIN AND VAGINAL BLEEDING. HOWEVER, SIGNS OF HEMORRHAGIC SYNDROME WERE OBSERVED AS HYPOTENSION AND SHOCK, SUCH AS SKIN PALENESS AND ASTHENIA. THE CONDUCT WAS THE INTERRUPTION OF GESTATION WITH EMERGENCY CESAREAN SECTION AND STILLBIRTH EXTRACTION. TAKING INTO ACCOUNT THE POOR PROGNOSIS, IT IS CONCLUDED THAT CAREFUL PRENATAL MONITORING IS OF UTMOST IMPORTANCE, TAKING INTO ACCOUNT THE RISK FACTORS FOR PPD.