In the management of uterine rupture, which structure, when torn, most reliably predicts the need for emergency hysterectomy over uterine repair?

• A Anterior uterine wall rupture along previous caesarean scar
• B Complete rupture at the fundus
• C Rupture extending laterally into the broad ligament involving the uterine vessels ✓
• D Posterior wall rupture with peritoneal breach

Explanation

Lateral extension of uterine rupture into the broad ligament involving the uterine vessels causes torrential haemorrhage from disruption of the uterine artery and its branches, making haemostatic uterine repair extremely difficult or impossible. This pattern most reliably indicates the need for hysterectomy. Simple anterior scar dehiscence or fundal ruptures can often be repaired primarily. Posterior ruptures are rare and may also require hysterectomy depending on extent.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.