Case study of atonic internal postpartum haemorrhage following severe preeclampsia and caesarean section
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20205254Keywords:
Intrauterine postpartum haemorrhage, Couvelair's uterus, Caesarean section, Severe preeclampsia, Delayed diagnosis, Postpartum evaluationAbstract
Postpartum haemorrhage is most often diagnosed by visualizing external vaginal bleeding, however, in some cases the bleeding may be internal, which significantly increases the risk for delayed diagnosis. We present a case report of a puerperal woman with delayed diagnosis of internal postpartum haemorrhage, which is caused by the development of a Couvelair’s uterus after caesarean section, resulting in an acute hysterectomy.
References
Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2:323-33.
von Schmidt AJF, Hukkelhoven CW, van Roosmalen J, Bloemenkamp KW. Pre-eclampsia increases the risk of postpartum haemorrhage: a nationwide cohort study in the Netherlands. PLoS ONE. 2013;8(12):e81959.
Poggi SBH. Postpartum hemorrhage & the abnormal puerperium. In: DeCherney AH, Nathan L, Laufer N, Roman AS, eds. Current diagnosis & treatment: obstetrics & gynecology. 12th ed. United States: McGraw-Hill; 2019.
Deneux-Tharaux C, Bonnet MP, Tort J. Epidemiology of post-partum haemorrhage. J Gynecol Obstet Biol Reprod. 2014;43(10):936.
Helewa ME, Burrows RW, Smith J, Williams K, Brain P, Rabkin SW. Report of the Canadian hypertension society consensus conference: Definitions, evaluation and classification of hypertensive disorders in pregnancy. Can Med Assoc J. 1997;157:715-25.
Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170(1):1-7
Karumanchi SA, Maynard SE, Stillman IE, Epstein FH, Sukhatme VP. Preeclampsia: a renal perspective. Kidney Int. 2005;67:2101-13.
Rubí-Palacios FM, Duarte-Pineda AJ, Barón-Salgado AL, Vásquez Tercero IH, Zelaya-Guido CJ. Couvelaire uterus, consequence of premature placental detachment. A case report. Ginecol Obstet Mex. 2018;86(05):351-6.
Cipullo LMA, Poto GE, Zullo F, Merciai F, Guida M. Late complication of a couvelaire uterus: case report and literature review. J Preg Child Health. 2019;6:407.
Roztocka A, Ropacka-Lesiak M, Bręborowicz GH. Preeclamptic pregnancy complicated by huge retroplacental hematoma and Couvelaire uterus–a case report. Arch Perinat Med. 2014;20(4):217-23.
Frasure SA. Emergency delivery. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM, eds. Tintinalli’s emergency medicine: a comprehensive study guide. 9th ed. United States: McGraw-Hill; 2016:19.
American college of surgeons. Shock. In: American college of surgeons, eds. Advanced trauma life support (student manual). 10th ed. United States: American college of surgeons; 2018:50.
Sierra A, Burrel M, Sebastia C, Radosevic A, Barrufet M, Albela S, et al. Utility of multidetector ct in severe postpartum hemorrhage. Radio Graphics. 2012;32:1463-81.
Üçyiğit A, Johns J. The postpartum ultrasound scan. Ultrasound. 2016;24(3):163-9.
Lousquy R, Morel O, Soyer P, Malartic C, Gayat E, Barranger E. Routine use of abdominopelvic ultrasonography in severe postpartum hemorrhage: retrospective evaluation in 125 patients. Am J Obstet Gynecol. 2011;204:232.e1-6.
Avery DM, Wells MA. Couvelaire uterus as identified by ultrasound findings: a case report. Female Patient. 2008;33:29-30.
Evensen A, Anderson JM, Fontaine P. Postpartum hemorrhage: prevention and treatment. Am Fam Physician. 2017;95(7):442-9.
Cesarean delivery and peripartum hysterectomy. section: postoperative care. In: Cunningham F, Leveno KJ, Bloom SL, Dashe JS, Hoffman BL, Casey BM, Spong CY. eds. Williams obstetrics. 25th ed. United States: McGraw-Hill; 2018.
Frasure SA. Emergency delivery. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM, eds. Tintinalli’s emergency medicine: a comprehensive study guide. 9th ed. United States: McGraw-Hill; 2016:19.
Cortet M, Deneux-Tharaux C, Dupont C, Colin C, Rudigoz RC, Bouvier-Colle MH, et al. Association between fibrinogen level and severity of postpartum haemorrhage: secondary analysis of a prospective trial. Br J Anaesth. 2012;108(6):984-9.
Koopmans CM, Van der Tuuk K, Groen H, Doornbos JPR, De Graaf IM, Van der Salm PCM, et al. Prediction of postpartum hemorrhage in women with gestational hypertension or mild preeclampsia at term. Acta Obstet Gynecol Scand. 2014;93:399-407.
Sheiner E, Sarid L, Levy A, Seidman DS, Hallak M. Obstetric risk factors and outcome of pregnancies complicated with early postpartum hemorrhage: a population-based study. J Matern Fetal Neonatal Med. 2005;18(3):149.
Nyfløt LT, Sandven I, Stray-Pedersen B, Pettersen S, Al-Zirqi I, Rosenberg M, et al. Risk factors for severe postpartum hemorrhage: a case-control study. BMC Pregnancy Childbirth. 2017;17(1):17.
Mavrides E, Allard S, Chandraharan E, Collins P, Green L, Hunt BJ, et al. Prevention and management of postpartum haemorrhage. BJOG Int J Obstet Gynecol. 2016;124:e106-49.
Pakniat H, Khezri MB. The Effect of combined oxytocin-misoprostol versus oxytocin and misoprostol alone in reducing blood loss at cesarean delivery: a prospective randomized double-blind study. J Obstet Gynaecol India. 2015;65(6):376-81.
Salati JA, Leathersich SJ, Williams MJ, Cuthbert A, Tolosa JE. Prophylactic oxytocin for the third stage of labour to prevent postpartum haemorrhage. Cochrane Database Syst Rev. 2019;4:CD001808.
Gallos ID, Papadopoulou A, Man R, Athanasopoulos N, Tobias A, Price MJ, et al. Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev. 2018; 12:CD011689.
Chai VYK, To WWK. Uterine compression sutures for management of severe postpartum haemorrhage: five-year audit. Hong Kong Med J. 2014;20:117.
Gilmandyar D, Thornburg LL. Surgical management of postpartum hemorrhage. Semin Perinatol. 2019;43 (1):27-34
Doumouchtsis SK, Nikolopoulos K, Talaulikar V, Krishna A, Arulkumaran S. Menstrual and fertility outcomes following the surgical management of postpartum haemorrhage: a systematic review. BJOG Int J Obstet Gynecol. 2014;121(4):382.
Rathi M, Rathi SK, Purohit M, Pathak A. Couvelaire uterus. BMJ Case Rep. 2014;2014:bcr2014204211.
Shikanova S, Karimova B, Sarsembayev M, Abdelazim IA, Starchenko T, Bekzhanova M. Successful management of severe preeclampsia major complications: Case report. J Family Med Prim Care. 2019;8:2147-9.
