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Uterine rupture — DRCOG MCQ

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HardLabourUterine ruptureDRCOG

A 34-year-old woman with one previous caesarean is labouring for VBAC. She develops sudden constant abdominal pain, vaginal bleeding and an abnormal CTG. The presenting part is now higher on abdominal examination. What is the most likely diagnosis?

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Correct answer: C — Uterine rupture

The combination of previous caesarean scar, sudden pain, bleeding, abnormal CTG and loss of station is highly suggestive of uterine rupture. Abruption can cause pain and fetal distress, but the rising presenting part is a key discriminator. This is not normal transition pain. Scar tenderness alone would not explain acute fetal compromise and loss of station.

Reference: RCOG Green-top Guideline No. 45; NICE NG235