A pregnant client reports sharp pain, 9/10, high in the fundus. There is only minimal vaginal bleeding, but the abdomen is hard and her HR is 110. The nurse suspects


• Couvelaire uterus is a life-threatening condition in which abruptio placentae causes blood to infiltrate the uterine myometrium and the peritoneal cavity.

• A hard, board-like uterus is formed with minimal-to-no apparent bleeding seen.

• When placenta abruption occurs normally, there will be external bleeding if the placenta separates first at the edges and blood escapes freely from the cervix. If the center of the placenta separates first, blood will pool under the placenta and be hidden from view, causing couvelaire uterus.

• Incorrect: The remaining answer choices are pelvic types that determine whether a vaginal birth or C-section is indicated.

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