During trial of scar (trial of labour after cesarean, TOLAC), which single intrapartum finding is the most specific sign of complete uterine rupture as opposed to uterine dehiscence?
- A Variable decelerations on CTG
- B Maternal tachycardia and hypotension
- C Loss of previously felt fetal parts abdominally ✓
- D Sudden cessation of uterine contractions
Correct answer: C. Loss of previously felt fetal parts abdominally
Explanation
Loss of the previously palpable fetal presenting part (fetal parts can no longer be felt per abdomen at their prior station) indicates extrusion of fetal parts through the rupture site into the peritoneal cavity, which is pathognomonic of complete uterine rupture. Variable decelerations and maternal haemodynamic instability occur with many obstetric emergencies. Sudden cessation of contractions can accompany rupture but is not specific. The sudden absence of previously palpable fetal parts is the most specific sign of complete rupture.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.