Labour: uterine rupture: practice question

A OBG question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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OBG · Labour: uterine rupture

Sample item

A woman with a previous lower segment caesarean section in spontaneous labour suddenly develops severe abdominal pain, fetal heart rate falls to 70/min and the presenting part recedes. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Uterine rupture

Sudden pain, fetal bradycardia, loss of station, vaginal bleeding and maternal shock suggest uterine rupture. Management is emergency laparotomy and delivery with repair or hysterectomy. Rupture occurs in around 0.5 to 1 per cent of women attempting vaginal birth after one caesarean section.

Option by option

  • A. Normal second stage

    In a normal second stage the presenting part descends.

  • B. Placenta praevia

    Praevia causes painless bleeding.

  • C. Round ligament pain

    Round ligament pain does not cause fetal bradycardia.

  • D. Uterine rupture (correct)

    Correct. This is the classic presentation of rupture of a scarred uterus.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More OBG questions

Questions about this OBG question

What is the answer to this OBG question?

The best answer is D, Uterine rupture. Sudden pain, fetal bradycardia, loss of station, vaginal bleeding and maternal shock suggest uterine rupture.

Why is "Normal second stage" not the answer?

In a normal second stage the presenting part descends.

Why is "Placenta praevia" not the answer?

Praevia causes painless bleeding.

Why is "Round ligament pain" not the answer?

Round ligament pain does not cause fetal bradycardia.

What concept does this question test?

It tests Labour: uterine rupture in OBG. Management is emergency laparotomy and delivery with repair or hysterectomy. Rupture occurs in around 0.5 to 1 per cent of women attempting vaginal birth after one caesarean section.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Labour: uterine rupture?

Learn management algorithms as steps: PPH, eclampsia, ectopic pregnancy. Then use the flashcards and the other OBG questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.