A 35-year-old G2P1 with previous cesarean section undergoes a trial of labour at 39 weeks. She reaches 8 cm dilation but then develops a Bandl's ring with severe abdominal pain and cessation of contractions. Fetal heart rate is absent. What is the most likely diagnosis?
- A Placental abruption
- B Uterine atony
- C Uterine rupture ✓
- D Vasa previa rupture
Correct answer: C. Uterine rupture
Explanation
In a woman with a previous cesarean scar undergoing TOLAC, the development of a pathological retraction ring (Bandl's ring) with sudden severe abdominal pain and loss of fetal heart rate strongly suggests uterine rupture. This is a catastrophic obstetric emergency requiring immediate laparotomy.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.