Couvelaire Uterus

Question 1

• Uterus turns entirely blue
because the muscle fibers
are filled with blood

• Uterus contracts poorly after
birth

• Necessitates hysterecto

Answer 1

Couvelaire Uterus

Question 2

Signs and symptoms

Answer 2

• Bleeding (dark red), which
may be evident vaginally or
may be concealed behind
the placenta

• Uterus becomes tense and
feels rigid to touch

• Uterine tenderness that may
be localized

• Sharp stabbing pain in the uterine fundus

Question 3

Laboratory and Diagnostic procedures:

Answer 3

1.) Ultrasound

2.) Blood Exams (CBC, Hgb, Hct, Fibrinogen level)

Question 4

Many nursing assessments are concurrent with medical assessments and include…

Answer 4

– Amount and nature of bleeding

– Pain and uterine tenderness

– Maternal & fetal v/s

– Uterine contractions

– Obstetric Hx

– Laboratory results – CBC, bld. type,
coagulation studies ( fibrinogen, PT, PTT)

Question 5

CONSERVATIVE MANAGEMENT:
Fetus is immature and no signs of distress

Answer 5

1.) CBR

2.) Focus on cardiovascular status of mother and fetus

3.) Administer Tocolytics (decrease uterine contractions)

4.) Keep in lateral position

5.) NO IE, no edema

Question 6

Monitor for signs of hypovolemic shock like…

Answer 6

1.) Fetal tachycardia (Often first sign)

2.) Maternal tachycardia

3.) Normal or slightly decreased BP

4.) Increased RR

5.) Cool, pale skin and mucous membranes

LATE SIGNS:
1.) Falling BP
2.) Pallor, skin becomes cold
3.) Urine output is less than 30ml/hr
4.) restlessness and agitation

Question 7

Management:

Answer 7

1.) Monitor the fets

2.) Promoting tissue oxygenation

3.) Collaborating with the physician for fluid replacement

4.) Prepare woman for surgery

5.) Provide emotional support