クーベレール子宮
WordNet
- a hollow muscular organ in the pelvic cavity of females; contains the developing fetus (同)womb
PrepTutorEJDIC
- 子宮(womb)
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/01/30 15:07:36」(JST)
[Wiki en表示]
| Couvelaire uterus |
| Classification and external resources |
| ICD-10 |
O45.8 |
| ICD-9 |
641.2 |
Couvelaire uterus (also known as uteroplacental apoplexy)[1] is a life-threatening condition in which loosening of the placenta (abruptio placentae) causes bleeding that penetrates into the uterine myometrium forcing its way into the peritoneal cavity.
Contents
- 1 Symptoms and signs
- 2 Pathophysiology
- 3 Prevention
- 4 Treatment
- 5 Prognosis
- 6 References
Symptoms and signs
Patients can have pain secondary to uterine contractions, uterine tetany or localized uterine tenderness. Signs can also be due to abruptio placentae including uterine hypertonus, fetal distress, fetal death, and rarely, hypovolaemic shock (shock secondary to severe blood loss). The uterus may adopt a bluish/purplish, mottled appearance due to extravasation of blood into uterine muscle.
Pathophysiology
"Couvelaire uterus" is a phenomenon wherein the retroplacental blood may penetrate through the thickness of the wall of the uterus into the peritoneal cavity. This may occur after abruptio placentae. The hemorrhage that gets into the decidua basalis ultimately splits the decidua, and the haematoma may remain within the decidua or may extravasate into the myometrium (the muscular wall of the uterus). The myometrium becomes weakened and may rupture due to the increase in intrauterine pressure associated with uterine contractions. This may lead to a life-threatening obstetric emergency requiring urgent delivery of the fetus.
Prevention
The occurrence of couvelaire uterus can be prevented by prevention of abruptio placentae. This include proper management of hypertensive states of pregnancy; treatment of maternal diseases like diabetes mellitus, and other collagen disease complicating pregnancy; prevention of trauma during pregnancy; mothers should also avoid smoking or consumption of alcohol during pregnancy.
Treatment
The uterus should be evacuated and contractions should be stimulated using intravenous oxytocin; hysterectomy (the removal of the uterus) may be needed in some cases.
Prognosis
The fetus may be compromised if there is prolonged delivery because of the non-contractile uterus; severe bleeding may cause hypovolemic shock in the mother.
References
- ^ Hubbard JL, Hosmer SB (September 1997). "Couvelaire uterus". J Am Osteopath Assoc 97 (9): 536–7. PMID 9313351.
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Pathology of pregnancy, childbirth and the puerperium (O, 630–679)
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| Pregnancy |
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Pregnancy with
abortive outcome
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- Ectopic pregnancy
- Abdominal pregnancy
- Cervical pregnancy
- Interstitial pregnancy
- Ovarian pregnancy
- Molar pregnancy
- Miscarriage
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Oedema, proteinuria and
hypertensive disorders
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- Gestational diabetes
- Gestational hypertension
- Pre-eclampsia
- Eclampsia
- HELLP syndrome
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Other, predominantly
related to pregnancy
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Digestive system
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- Acute fatty liver of pregnancy
- Hepatitis E
- Hyperemesis gravidarum
- Intrahepatic cholestasis of pregnancy
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Integumentary system /
dermatoses of pregnancy
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- Gestational pemphigoid
- Impetigo herpetiformis
- Intrahepatic cholestasis of pregnancy
- Linea nigra
- Prurigo gestationis
- Pruritic folliculitis of pregnancy
- Pruritic urticarial papules and plaques of pregnancy (PUPPP)
- Striae gravidarum
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Nervous system
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Blood
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- Gestational thrombocytopenia
- Pregnancy-induced hypercoagulability
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Maternal care related to the
fetus and amniotic cavity
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- amniotic fluid
- Oligohydramnios
- Polyhydramnios
- Braxton Hicks contractions
- chorion / amnion
- Amniotic band syndrome
- Chorioamnionitis
- Chorionic hematoma
- Monoamniotic twins
- Premature rupture of membranes
- Obstetrical hemorrhage
- placenta
- Circumvallate placenta
- Monochorionic twins
- Placenta praevia
- Placental abruption
- Twin-to-twin transfusion syndrome
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| Labor |
- Amniotic fluid embolism
- Cephalopelvic disproportion
- Dystocia
- Fetal distress
- Locked twins
- Obstetrical hemorrhage
- placenta
- Preterm birth
- Postmature birth
- Umbilical cord prolapse
- Uterine rupture
- Vasa praevia
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| Puerperal |
- Breastfeeding difficulties
- Agalactia
- Fissure of the nipple
- Galactorrhea
- Breast engorgement
- Diastasis symphysis pubis
- Peripartum cardiomyopathy
- Postpartum depression
- Postpartum thyroiditis
- Puerperal fever
- Puerperal mastitis
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| Other |
- Concomitant conditions
- Diabetes mellitus
- Systemic lupus erythematosus
- Thyroid disorders
- Maternal death
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| Description |
- Pregnancy
- Development
- Anatomy
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| Disease |
- Pregnancy and childbirth
- Placenta and neonate
- Infections
- Symptoms and signs
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| Treatment |
- Procedures
- Drugs
- oxytocins
- labor repressants
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UpToDate Contents
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- 1. 胎盤早期剥離：管理 placental abruption management
- 2. 妊婦における腟出血の病因および評価の概要 overview of the etiology and evaluation of vaginal bleeding in pregnant women
English Journal
- [Couvelaire uterus in puerperium. A case report].
- Serrano-Berrones MA, Serrano-Berrones JR, Centeno-Durán G.
- Ginecología y obstetricia de México.Ginecol Obstet Mex.2014 Jul;82(7):496-8.
- Couvelaire uterus is rare in modern obstetrics, a state of the hematic infiltration uterine myometrium due to the formation of a massive hematoma retroplacental that can not be sold to the vaginal cavity through the cervical route. In all cases described in the present there is a history of placenta
- PMID 25102676
- Rathi M1, Rathi SK, Purohit M, Pathak A.
- BMJ case reports.BMJ Case Rep.2014 Mar 31;2014. pii: bcr2014204211. doi: 10.1136/bcr-2014-204211.
- PMID 24686812
- Uteroplacental apoplexy (Couvelaire syndrome).
- Habek D1, Selthofer R, Kulas T.
- Wiener klinische Wochenschrift.Wien Klin Wochenschr.2008;120(3-4):88. doi: 10.1007/s00508-008-0931-7.
- PMID 18322769
Related Links
- Cou·ve·laire uterus (ko o -və-lĕr′) n. Extravasation of blood into the uterine musculature and beneath the uterine peritoneum in association with premature detachment of the placenta. Couvelaire uterus [ko o vəler′] Etymology: Alexandre ...
- Couvelaire uterus definition at Dictionary.com, a free online dictionary with pronunciation, synonyms and translation. Look it up now! Added to Favorites Dictionary Thesaurus Word Dynamo Quotes Reference Translator Spanish n. ...
- 1. J Am Osteopath Assoc. 1997 Sep;97(9):536-7. Couvelaire uterus. Hubbard JL, Hosmer SB. Uteroplacental apoplexy is a rare but nonfatal complication of severe forms of placental abruption. It occurs when vascular damage within ...
★リンクテーブル★
[★]
- 英
- abruption of the placenta, abruption of placenta, premature separation of the placenta, ablation of the placenta, ablation of placenta, placental abruption
- ラ
- abruptio placentae, ablatio placentae
- 同
- 子宮胎盤溢血 uteroplacental apoplexy, Couvelaire uterus
- 関
- 常位胎盤早期剥離
[★]
- 英
- Couvelaire uterus
- 同
- Couvelaire子宮
- 関
- 常位胎盤早期剥離、クーベレール胎盤 Couvelaire placenta