The global prevalence of depression, anxiety, and sleep disorder among patients coping with Post COVID-19 syndrome (long COVID): a systematic review and meta-analysis.

BACKGROUND: Post COVID-19 syndrome, also known as "Long COVID," is a complex and multifaceted condition that affects individuals who have recovered from SARS-CoV-2 infection. This systematic review and meta-analysis aim to comprehensively assess the global prevalence of depression, anxiety, and sleep disorder in individuals coping with Post COVID-19 syndrome. METHODS: A rigorous search of electronic databases was conducted to identify original studies until 24 January 2023. The inclusion criteria comprised studies employing previously validated assessment tools for depression, anxiety, and sleep disorders, reporting prevalence rates, and encompassing patients of all age groups and geographical regions for subgroup analysis Random effects model was utilized for the meta-analysis. Meta-regression analysis was done. RESULTS: The pooled prevalence of depression and anxiety among patients coping with Post COVID-19 syndrome was estimated to be 23% (95% CI: 20%-26%; I2 = 99.9%) based on data from 143 studies with 7,782,124 participants and 132 studies with 9,320,687 participants, respectively. The pooled prevalence of sleep disorder among these patients, derived from 27 studies with 15,362 participants, was estimated to be 45% (95% CI: 37%-53%; I2 = 98.7%). Subgroup analyses based on geographical regions and assessment scales revealed significant variations in prevalence rates. Meta-regression analysis showed significant correlations between the prevalence and total sample size of studies, the age of participants, and the percentage of male participants. Publication bias was assessed using Doi plot visualization and the Peters test, revealing a potential source of publication bias for depression (p = 0.0085) and sleep disorder (p = 0.02). However, no evidence of publication bias was found for anxiety (p = 0.11). CONCLUSION: This systematic review and meta-analysis demonstrate a considerable burden of mental health issues, including depression, anxiety, and sleep disorders, among individuals recovering from COVID-19. The findings emphasize the need for comprehensive mental health support and tailored interventions for patients experiencing persistent symptoms after COVID-19 recovery.

Early detection of squamous cell carcinoma of the oral tongue using multidimensional plasma protein analysis and interpretable machine learning.

BACKGROUND: Interpretable machine learning (ML) for early detection of cancer has the potential to improve risk assessment and early intervention. METHODS: Data from 261 proteins related to inflammation and/or tumor processes in 123 blood samples collected from healthy persons, but of whom a sub-group later developed squamous cell carcinoma of the oral tongue (SCCOT), were analyzed. Samples from people who developed SCCOT within less than 5 years were classified as tumor-to-be and all other samples as tumor-free. The optimal ML algorithm for feature selection was identified and feature importance computed by the SHapley Additive exPlanations (SHAP) method. Five popular ML algorithms (AdaBoost, Artificial neural networks [ANNs], Decision Tree [DT], eXtreme Gradient Boosting [XGBoost], and Support Vector Machine [SVM]) were applied to establish prediction models, and decisions of the optimal models were interpreted by SHAP. RESULTS: Using the 22 selected features, the SVM prediction model showed the best performance (sensitivity = 0.867, specificity = 0.859, balanced accuracy = 0.863, area under the receiver operating characteristic curve [ROC-AUC] = 0.924). SHAP analysis revealed that the 22 features rendered varying person-specific impacts on model decision and the top three contributors to prediction were Interleukin 10 (IL10), TNF Receptor Associated Factor 2 (TRAF2), and Kallikrein Related Peptidase 12 (KLK12). CONCLUSION: Using multidimensional plasma protein analysis and interpretable ML, we outline a systematic approach for early detection of SCCOT before the appearance of clinical signs.

Comparison of Preoperative Positron Emission Tomography/Computed Tomography with Panscopy and Ultrasound in Patients with Head and Neck Cancer.

INTRODUCTION: To compare data from preoperative positron emission tomography/computed tomography (PET/CT) with results of panscopy with biopsy and ultrasound with fine needle aspiration cytology (US-FNAC) on the same patients. METHODS: In this retrospective (2014-2016) study, we compared PET/CT results with the results from panscopy with biopsy and US-FNAC in patients suspected of head and neck malignancy treated at the University Hospital in Umeå, Sweden. RESULTS: A 91.3% concordance was seen between results from PET/CT and panscopy with biopsy, whereas between PET/CT and US-FNAC the concordance was 89.1%. CONCLUSIONS: The present data show the usefulness of PET/CT in the diagnosis of head and neck malignancies.

p75NTR-dependent Rac1 activation requires receptor cleavage and activation of an NRAGE and NEDD9 signaling cascade.

The p75 neurotrophin receptor (p75NTR, also known as tumor necrosis factor receptor superfamily member 16) is implicated in diverse cellular events, but fundamental aspects of its signaling mechanisms remain unclear. To address this, we have established a novel bioassay to characterize signaling cascades activated by p75NTR. We show that in COS7 cells, p75NTR expression causes a large increase in cell surface area that relies on the activation of Rac1, and we demonstrate that the p75NTR-dependent COS7 phenotype is dependent on ADAM17- and c-secretase-dependent cleavage of p75NTR and generation of the p75NTR intracellular domain (p75NTRICD). We show that the p75NTR adaptor protein NRAGE (also known as MAGED1) acts downstream of the p75NTRICD in this cascade and, through a yeast two-hybrid screen, identify NEDD9, a Cas family adaptor protein, as a novel NRAGE-binding partner that mediates p75NTR-dependent Rac1 activation and cell spreading. Our results demonstrate a crucial role for p75NTR cleavage in small GTPase activation and define a novel Rac1 activation pathway involving the p75NTRICD, NRAGE andNEDD9.

Length-Scale-Dependent Phase Transformation of LiFePO4 : An In situ and Operando Study Using Micro-Raman Spectroscopy and XRD.

The charge and discharge of lithium ion batteries are often accompanied by electrochemically driven phase-transformation processes. In this work, two in situ and operando methods, that is, micro-Raman spectroscopy and X-ray diffraction (XRD), have been combined to study the phase-transformation process in LiFePO4 at two distinct length scales, namely, particle-level scale (∼1 µm) and macroscopic scale (∼several cm). In situ Raman studies revealed a discrete mode of phase transformation at the particle level. Besides, the preferred electrochemical transport network, particularly the carbon content, was found to govern the sequence of phase transformation among particles. In contrast, at the macroscopic level, studies conducted at four different discharge rates showed a continuous but delayed phase transformation. These findings uncovered the intricate phase transformation in LiFePO4 and potentially offer valuable insights into optimizing the length-scale-dependent properties of battery materials.

A new route for synthesis of silver:gold alloy nanoparticles loaded within phosphatidylcholine liposome structure as an effective antibacterial agent against Pseudomonas aeruginosa.

Ag:Au alloy nanoparticles were successfully synthesized through the new route using co-reduction method with silver nitrate, chloroauric acid, cetyl trimethyl ammonium bromide (CTAB) and sodium borohydride at room temperature. The Ag:Au alloy nanoparticles were then loaded within the phosphatidylcholine (97%) liposome structure. Various molar ratios of phosphotidylcholine and CTAB to the total metals were investigated showing its importance on the stability of nanocomposites suspension. The size distribution and morphology of encapsulated nanoparticles within the liposome structure were studied via ultraviolet (UV)-visible spectrum, transmission electron microscope (TEM) micrographs, and dynamic light scattering data. The synthesis of alloy nanoparticles were confirmed with formation of single band at 430, 465 and 500 nm for 75:25, 50:50 and 25:75 Ag:Au mole ratios, respectively. The TEM micrographs of different samples indicated formation of three various nanocomposite structures with size of 82-300 nm. The antibacterial activities of Ag:Au nanocomposites were studied against Pseudomonas aeruginosa through well-diffusion agar. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined by Broth microdilution method. The results showed that 10 ppm nanocomposite reasonably killed the above bacteria.

Misleading Rare Case of Idiopathic Hypertrophic Pachymeningitis.

Idiopathic hypertrophic pachymeningitis (IHP) is a rare disease with diffuse thickening of the dura mater that has no specific clinical symptoms and manifestations and it causes neurosurgeons to misdiagnose. A 4-year-old girl presented at the emergency room of our hospital with speech difficulty and severe headache. Head computed tomography scans (CT scan) on admission revealed a large fluid collection over the right temporoparietal region with mass effect, and the neurosurgeon drained it with the initial diagnosis of subdural hematoma. However, the postoperative CT scan demonstrated the failure of surgical drainage; therefore, magnetic resonance imaging (MRI) was requested for the patient. MRI identified diffuse nodular dural thickening with internal septations and different internal hemorrhagic stages on the right side with no evidence of brain parenchymal involvement and according to the serology and autoimmune screening tests, and IHP was diagnosed for the patient. The patient underwent craniotomy. There was an immediate improvement of neurologic symptoms. The patient had good clinical and radiologic outcome at 3 -months follow-up. IHP should be part of the differential diagnosis of some cases of noncommunicating hydrocephalus; however, the rarity of the disease and the absence of specific clinical symptoms make the diagnosis difficult.

A cluster-based SMOTE both-sampling (CSBBoost) ensemble algorithm for classifying imbalanced data.

In this paper, a Cluster-based Synthetic minority oversampling technique (SMOTE) Both-sampling (CSBBoost) ensemble algorithm is proposed for classifying imbalanced data. In this algorithm, a combination of over-sampling, under-sampling, and different ensemble algorithms, including Extreme Gradient Boosting (XGBoost), random forest, and bagging, is employed in order to achieve a balanced dataset and address the issues including redundancy of data after over-sampling, information loss in under-sampling, and random sample selection for sampling and sample generation. The performance of the proposed algorithm is evaluated and compared to different state-of-the-art competing algorithms based on 20 benchmark imbalanced datasets in terms of the harmonic mean of precision and recall (F1) and area under the receiver operating characteristics curve (AUC) measures. Based on the results, the proposed CSBBoost algorithm performs significantly better than the competing algorithms. In addition, a real-world dataset is used to demonstrate the applicability of the proposed algorithm.

Liraglutide and Liver Injury: Rare Case Report with Literature Review.

BACKGROUND: Liraglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist used for the treatment of type 2 diabetes mellitus (T2DM). So far, few severe side effects have been reported for it. CASE PRESENTATION: A 41-year-old woman was admitted to the Emergency Room with diffuse abdominal pain. The patient had a known case of T2DM, fatty liver disease, and hypertension and was treated with Metformin, Liraglutide, and Losartan. Her liver functional test (LFT) was consistent with hepatocellular injury; however, laboratory tests and abdominal ultrasound were used to rule out autoimmune hepatitis. Due to concerns for drug-induced liver injury (DILL), liraglutide was discontinued and N-acetyl cysteine was prescribed. On the fifth day of hospitalization, the patient's symptoms resolved and his LFT started to decrease on the sixth day after 2 months, the patient's liver enzyme levels returned to normal. CONCLUSION: Liraglutide is one of the most important drugs in the treatment of T2DM.The most common side effects of this drug are constipation, nausea, vomiting, diarrhea, indigestion, and loss of appetite. In rare cases, symptoms of thyroid cancer, pancreatitis, and hypoglycemia have been reported, however, DILL is one of the extremely rare side effect of Liraglutide. It is important to increase the awareness of physicians about the liver injury of Liraglutide.

The environmental risk factors associated with fetal macrosomia: An umbrella review.

The present umbrella review evaluated the environmental risk factors prior to conception associated with fetal macrosomia based on meta-analyses and systematic reviews. We systematically searched international databases, including PubMed, Scopus, and Web of Science, until April 2023 by using some relevant keywords. The quality of the included studies was assessed using the AMSTAR 2checklist. The risk factor of advanced maternal age 35-39 years compared with <30 years (OR 1·42, 95 % CI: 1·25, 1·60), prepregnancy obesity (OR 1.93, 95 % CI: 1.65, 2.27) and excessive weight gain before and during pregnancy (OR 2.35, 95 % CI: 1.95, 2.85) were graded as suggestive evidence (class III). Two risk factors of advanced maternal age >40 years compared with <30 years (OR 1.40, 95 % CI: 1.02, 1.78) and gestational diabetes mellitus (GDM) without insulin use (OR 1.70, 95 % CI: 1.23, 2.36) were graded as risk factors with weak evidence (class IV). Advanced maternal age, prepregnancy obesity, excessive weight gain before and during pregnancy, and GDM without insulin use were environmental risk factors for macrosomia.

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms.

OBJECTIVE: To evaluate intraoperative factors predicting appendiceal pathology during gynecologic oncology surgery for suspected mucinous ovarian neoplasms. METHODS: We conducted a retrospective study on 225 patients with mucinous ovarian neoplasms who underwent surgery for an adnexal mass with concurrent appendectomy between 2000 and 2018. Regression analyses were used to evaluate intraoperative factors, such as frozen section of the ovarian mass and surgeon's impression of the appendix in predicting appendiceal pathology. RESULTS: Most patients (77.8%) had a normal appendix on final pathology. Abnormal appendix cases (n = 26) included: metastasis from high-grade adenocarcinoma of the ovary (n = 1), neuroendocrine tumor of the appendix (n = 4), and low-grade appendiceal mucinous neoplasms (n = 26; 23 associated with a mucinous ovarian adenocarcinoma, 2 with a benign mucinous ovarian cystadenoma, and 1 with a borderline mucinous ovarian tumor). Combining normal intraoperative appearance of the appendix with benign or borderline frozen section yielded a negative predictive value of 85.1%, with 14.9% of patients being misclassified, and 6.0% having a neuroendocrine tumor or low-grade appendiceal neoplasm. CONCLUSION: Benign or borderline frozen section of an ovarian mucinous neoplasm and normal appearing appendix have limited predictive value for appendiceal pathology. Appendectomy with removal of the mesoappendix should be considered in all cases of mucinous ovarian neoplasm, regardless of intraoperative findings.

Patients with oral tongue squamous cell carcinoma and co­existing diabetes exhibit lower recurrence rates and improved survival: Implications for treatment.

Locoregional recurrences and distant metastases are major problems for patients with squamous cell carcinoma of the head and neck (SCCHN). Because SCCHN is a heterogeneous group of tumours with varying characteristics, the present study concentrated on the subgroup of squamous cell carcinoma of the oral tongue (SCCOT) to investigate the use of machine learning approaches to predict the risk of recurrence from routine clinical data available at diagnosis. The approach also identified the most important parameters that identify and classify recurrence risk. A total of 66 patients with SCCOT were included. Clinical data available at diagnosis were analysed using statistical analysis and machine learning approaches. Tumour recurrence was associated with T stage (P=0.001), radiological neck metastasis (P=0.010) and diabetes (P=0.003). A machine learning model based on the random forest algorithm and with attendant explainability was used. Whilst patients with diabetes were overrepresented in the SCCOT cohort, diabetics had lower recurrence rates (P=0.015 after adjusting for age and other clinical features) and an improved 2-year survival (P=0.025) compared with non-diabetics. Clinical, radiological and histological data available at diagnosis were used to establish a prognostic model for patients with SCCOT. Using machine learning to predict recurrence produced a classification model with 71.2% accuracy. Notably, one of the findings of the feature importance rankings of the model was that diabetics exhibited less recurrence and improved survival compared with non-diabetics, even after accounting for the independent prognostic variables of tumour size and patient age at diagnosis. These data imply that the therapeutic manipulation of glucose levels used to treat diabetes may be useful for patients with SCCOT regardless of their diabetic status. Further studies are warranted to investigate the impact of diabetes in other SCCHN subtypes.

The effect of using treated domestic wastewater with different pHs on workability, mechanical, and durability properties of self-compacting concrete.

In the present work, we used treated domestic wastewater with different pHs in self-compacting concrete (SCC) to find the effect of treated wastewater with different pHs on the workability, mechanical, and durability properties of SCC. Eight different SCC mixtures were designed, including two control samples using tap water with a water-to-cement ratio (W/C) of 0.5 with 400 kg/m3 of cement and W/C of 0.36 with 440 kg/m3 of cement. Six SCC samples with the same characteristics as control samples except using treated domestic treated wastewater with different pHs. The results indicate that the workability of the SCC sample using the treated domestic wastewater in acidic pH was higher than the alkalinity state. Using treated domestic wastewater instead of tap water in SCC samples decreased compressive, flexural strength, and fracture toughness by less than 10%. Also, carbonation, 30-min water adsorption, and capillary water adsorption of SCC samples increased when treated domestic wastewater was used. The compressive strength of SCC samples made with treated domestic wastewater in an acidic state is less than about 5% in an alkaline state. The energy dispersive spectroscopy and the scanning electron microscope images confirmed that using treated wastewater instead of tap water, in SCC samples, reduced compressive strength because the Ca/Si ratio increased when treated domestic wastewater was used. The SCC samples with treated domestic wastewater in the alkaline state have a lower Ca/Si ratio. The higher compressive strength belongs to concrete samples that used treated domestic wastewater in an alkaline environment with a lower Ca/Si ratio.

Pre and perinatal predictors on autism spectrum disorders: a case-control study in the west of Iran.

INTRODUCTION: The constellation of pre and perinatal predictors are introduced as predictor for autism spectrum disorders (ASD), however, the information about the direction and strength of these predictors are lacking in Western, Iran. The current study aimed to determine the pre and perinatal predictors of ASD among children in this region. METHODS: This case-control study was conducted in Hamadan, Western Iran during January to March 2022. The study included 100 children with ASD who referred to the autism center as case group. Hundred children without ASD from registration system of health service centers were selected as control group and were matched (1:1) to cases by age and place of residency. A structured questionnaire about pre and perinatal predictors of ASD was developed by an expert panel. The questionnaire was administered by interviewing the mothers of children. RESULTS: Boy gender (OR: 3.51, 95% CI: 1.74-7.10, p-value < 0.001), small for gestational age (SGA) (3.92, 1.64-9.39, 0.002), maternal diabetes (3.51, 1.03-24.95, 0.04) and family history of mental disorders (3.64, 1.18-11.27, 0.04) were identified as significant predictors in a multivariable analysis. CONCLUSION: Our study emphasizes on the importance of screening and monitoring for ASD in the boys, those with history of SGA, from mothers with history of diabetes and with family history of mental disorders. Proposing the replication of findings emphasizes the necessity of conducting studies with larger sample sizes.

Neonatal risk factors associated with autism spectrum disorders: an umbrella review.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by severe social communication deficits and stereotypical repetitive behaviors. PURPOSE: This umbrella review assessed neonatal risk factors associated with ASD using meta-analyses and systematic reviews. METHODS: We conducted a systematic search of interna- tional databases including PubMed, Scopus, and Web of Science for studies published through April 2022 utilizing pertinent keywords. A random-effects model was used to calculate the odds ratio (OR) and 95% confidence interval (CI). Substantial heterogeneity was considered at values of I2≥50%. A quality assessment of the included studies was performed using the A MeaSurement Tool to Assess Systematic Reviews (AMSTAR2) checklist. RESULTS: A total of 207,221 children with ASD and 22,993,128 neurotypical children were included. Six meta- analyses were included in this umbrella review. The factors of congenital heart disease (OR, 1.35; 95% CI, 1.17-1.52), macrosomia (OR, 1.11; 95% CI, 1.05-1.18), low birth weight (OR, 1.63; 95% CI, 1.48-1.81), very low birth weight (OR, 2.25; 95% CI, 1.79-2.83), small for gestational age (OR, 1.17; 95% CI, 1.09-1.24), jaundice (OR, 1.74; 95% CI, 1.42- 2.12), male sex (OR, 1.47; 95% CI, 1.39-1.55) and 1-minute Apgar score <7 (OR, 1.40; 95% CI, 1.26-1.55) were graded as suggestive evidence (class III). Only 3 studies reported heterogeneity (I2<50%). Based on the AMSTAR2 analysis, the methodological quality was critically low in 3 meta- analyses, low in 2, and moderate in 1. CONCLUSION: Based on these results, clinicians should consider the risk factors for ASD and screen children in clinics.

Aerococcus viridans native valve endocarditis.

Aerococcus viridans is an infrequent human pathogen and few cases of infective endocarditis have been reported. A case involving a 69-year-old man with colon cancer and hemicolectomy 14 years previously, without recurrence, is reported. A diagnosis of native mitral valve endocarditis was established on the basis of clinical presentation, characteristic echocardiographic findings and pathological specimen examination after urgent valve replacement. A viridans endocarditis appears to be particularly virulent, requiring a surgical approach in four of 10 cases reported and death in one of nine. Given the aggressive nature of A viridans endocarditis and the variable time to diagnosis (a few days to seven months), prompt recognition of symptoms and echocardiography, in addition to blood cultures, should be performed when symptoms persist.

L'Aerococcus viridans est un pathogène humain peu fréquent qui s'associe à peu de cas déclarés d'endocardite infectieuse. Les auteurs présentent le cas d'un homme de 69 ans atteint d'un cancer du côlon et ayant subi une hémicolectomie 14 ans auparavant, sans récurrence depuis. Les médecins ont posé un diagnostic d'endocardite de la valvule mitrale naturelle d'après la présentation clinique, les observations échocardiographiques caractéristiques et l'examen des échantillons pathologiques après un remplacement valvulaire d'urgence. L'endocardite à A viridans semble particulièrement virulente. Elle a exigé une approche chirurgicale dans quatre des dix cas déclarés, et a suscité un décès dans un cas sur neuf. Étant donné le caractère agressif de l'endocardite à A viridans et le délai variable avant le diagnostic (de quelques jours à quelques mois), il faut en reconnaître rapidement les symptômes et ajouter une échocardiographie aux hémocultures en cas de persistance des symptômes.

The extremely rare case of aortic chordae tendineae strands: A case report with literature review.

The aortic chordae tendineae strands (ACTS) is a rare complication that can induce aortic regurgitation. Reported cases of ACTS are very few, and this is the first case reported in Iran. Patients with unexplained aortic regurgitation should be carefully evaluated for ACTS, which can be easily observed by TEE; a decision regarding aortic valve surgery should be made based on the severity of AR. Herein we reported A 64-year-old male was admitted to our hospital for dyspnea on exertion. In transthoracic Echocardiography a fibrous band-like chordae in the aortic root attached to the noncoronary cusp of the aorta was seen, which caused retraction of the noncoronary cusp, mal-coaptation of the aortic valves, and severe eccentric jet posterior directed aortic regurgitation. As a result of the ACTS, the patient was diagnosed with severe aortic regurgitation (AR); due to the symptomatic severe AR, the patient underwent aortic valve surgical replacement.

The association between post-term births and autism spectrum disorders: an updated systematic review and meta-analysis.

BACKGROUND: This study aimed to conduct a meta-analysis to determine whether post-term birth has an increased risk of ASD. MATERIALS AND METHODS: To retrieve eligible studies regarding the effect of post-term and ASD in children, major databases including PubMed, Scopus, and Web of Science were searched. A random effect model was used for meta-analysis. For assessing the quality of included studies, the GRADE checklist was used. RESULTS: In total, 18 records were included with 1,412,667 sample populations from 12 countries. The pooled estimates of RR and OR showed a significant association between post-term birth and ASD among children, respectively (RR = 1.34, 95% CI 1.10 to 1.58) and (OR = 1.47, 95% CI 1.03 to 1.91). There was no heterogeneity among the studies that reported the risk of ASD among children based on RR (I2 = 6.6%, P = 0.301). There was high heterogeneity in the studies reported risk of ASD based on OR (I2 = 94.1%, P = 0.000). CONCLUSION: Post-term births still occur relatively frequently (up to 5-10%) even in developed countries. Our results showed that post-term birth is an increased risk of ASD, although high heterogeneity was found among the studies reported based on adjusted and crude forms, however, after subgroup analysis by gender, this heterogeneity disappeared among males.

Development of Peptic Ulcer following Second Shot of Sputnik V Vaccine: A Case Report and Literature Review of Rare Side Effects of Sputnik V Vaccine.

Considering the global spread of the coronavirus disease 2019 (COVID-19), it is expected that vaccination against its causative agent, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), will reduce the related morbidity and mortality. However, the safety of the COVID-19 vaccines and their potential and unknown side effects are a matter of concern. With the ongoing development and implementation of COVID-19 vaccination programs around the world, the side effects, safety, and effectiveness of these vaccines are gradually being reported, providing researchers with valuable information that can affect the production and utilization of the COVID-19 vaccines. The present study intended to report a case of peptic ulcer disease (PUD) development following vaccination with Gam-COVID-Vac, a vector-based COVID-19 vaccine containing two recombinant human adenoviruses (rAd26 and rAd5).

Report of a Complicated Case of Couvelaire Uterus.

Couvelaire uterus (CU) is a rare complication in the life-threatening placental abruption (PA) that consists of a state of blood infiltration of the uterine myometrium and serosa. The incidence is around 1% and the treatment of choice is obstetric hysterectomy, however, in some cases, close monitoring and timely decision-making can prevent hysterectomy. Herein, we present a rare and serious case of CU with uterus preservation in a young multiparous with a high-risk pregnancy.