UTERUS - Abruptio placentae - de Couvelaire

This is a uterus of the size expected immediately post partum, but deep red in colour (de Couvelaire) - infiltration of the uterine wall by blood, said to occur in 5% of all cases of abruptio placentae.
This woman was admitted to hospital at the age of 44 in her ninth pregnancy, with an elevated blood pressure, ankle oedema and proteinuria. Some three weeks after admission she presented with pain in the back, vaginal bleeding and clonic uterine contractions. The foetal parts could not be felt, and a diagnosis of abruptio placentae was made. She was delivered of a still-born child, and a sub-total hysterectomy perfomed.