A cesarean section is performed, and the uterine incision is made vertically through the upper uterine segment. Which of the following is a major long-term consequence of this type of uterine incision compared to a low transverse incision?

• A Increased risk of bladder injury
• B Greater blood loss during the current surgery
• C Higher risk of uterine rupture in subsequent pregnancies ✓
• D Higher incidence of postoperative infection

Explanation

A classical cesarean incision involves the upper uterine segment. It carries a significantly higher risk of uterine rupture in subsequent pregnancies (4% to 9%) compared to a low transverse incision (0.5% to 1%). While blood loss might be slightly higher, the risk of future rupture is the most critical long-term consequence that dictates the need for repeat cesarean delivery.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.