A 28-year-old woman at term presents with sudden severe abdominal pain, uterine rigidity, and dark vaginal bleeding. The fetal heart rate is absent. On opening the abdomen for emergency laparotomy, the uterus appears purple and ecchymotic. This finding is pathognomonic of:

• A Placenta accreta
• B Uterine rupture
• C Couvelaire uterus (uteroplacental apoplexy) ✓
• D Adenomyosis

Explanation

Couvelaire uterus is extravasation of blood into the myometrium and serosa due to severe abruptio placentae, causing a purple, ecchymotic uterus. It is pathognomonic of severe abruption. Uterine rupture shows a rent in the uterine wall. Placenta accreta shows abnormal placental attachment without myometrial discoloration.

Reference: Dutta's Textbook of Obstetrics, 9th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.