The possibility of using organ-sparing tactics in patients with a Couvelaire uterus

Placental abruption is one of the most life-threatening and dramatic complications encountered in obstetric practice. The severe form of placental abruption with the formation of a retroplacental hematoma, the so-called Couvelaire uterus, is a serious accident in the second half of pregnancy and during childbirth with severe consequences for the mother and fetus, which often lead to a fatal outcome. The article presents a review of literature on the management tactics for pregnant women and parturients with premature detachment of the normally situated placenta, which is complicated by the development of Couvelaire uterus. Much attention is paid to the possibility of choosing organ-sparing tactics for this pathology. Using six cases from their own clinical practice as an example, the authors demonstrate the possibility of organ-sparing surgery for Couvelaire uterus. Conclusion. The complex process of choosing a surgical intervention directly depends on the amount of blood loss, hemodynamic parameters, and the severity of disorders in the hemostatic system, and uterine contractility. It is also necessary to take into account the general condition of a woman, her desire to preserve the uterus, as well as the level of equipment in the facility, and the capabilities of a surgeon. An individual approach ensures the success of a surgical intervention and the favorable course of the postoperative period.

placental abruption, Couvelaire uterus, perinatal mortality, hysterectomy