Couvelaire uterus

Couvelaire uterus is a rare, non-fatal but severe complication of placental abruption. 

Epidemiology

Its incidence is ~5% in all cases of placental abruption ¹. 

Pathology

It is caused by the seeping of blood/hematic infiltrate into the decidua basalis emerging as massive hematoma retroplacentally.

There is a classical blue/purple color change of the uterus wall, representing hemorrhage induced by disseminated intravascular coagulation ^3-5. 

Ultimately it may result in placental separation. 

Treatment and prognosis

This condition is managed on a non-operative basis ^2-4.