A 41-week pregnant woman, G1P0 with a history of previous LSCS, presents in labor. On examination, a pathological grove ring is noted as a horizontal ridge across the abdomen. What is this finding called?

1. A

   Uterus rupture

2. B

   Bandl's ring

3. C

   Hegar's sign

4. D

   Uterus Atrophy

Appeared in: NORCET 10 Prelims-2026

Explanation

Listen in Hindi

• Bandl's ring is a pathological retraction ring that forms at the junction of the actively contracting upper uterine segment and the dangerously thinned, passive lower uterine segment.
• It is a hallmark sign of obstructed labor, where the fetus cannot descend despite strong uterine contractions.
• The ring appears as a visible or palpable horizontal groove across the abdomen, often rising as the obstruction continues.
• Its presence is an obstetric emergency, signaling that the lower uterine segment is under extreme tension and is at imminent risk of rupture.
• This risk is particularly high in women with a prior uterine scar, such as from a previous C-section (LSCS).

Why Other Options Were Wrong

• Option A: Uterine rupture is the catastrophic event that Bandl's ring precedes. The ring is a warning sign of impending rupture, not the rupture itself. Rupture involves a full-thickness tear of the uterine wall.
• Option C: Hegar's sign is a probable sign of early pregnancy (first trimester), characterized by the softening of the uterine isthmus. It is completely unrelated to labor complications.
• Option D: Uterine atrophy is the shrinking of the uterus, which is a normal physiological process after menopause due to decreased estrogen levels. It is the opposite of the uterine hypertrophy seen in pregnancy.

Related Visual

• Visual 1: Diagram - An illustration showing the uterus in obstructed labor. It should clearly label the thickened upper segment, the thinned and stretched lower uterine segment, and the pathological retraction ring (Bandl's ring) at the junction between them.
• Visual 2: Illustration - A drawing of a pregnant woman's abdomen showing the visible horizontal ridge of Bandl's ring, contrasting it with the normal contour of a pregnant abdomen.

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The question tests the knowledge of clinical signs associated with obstructed labor, specifically the identification of a pathological retraction ring as background academic context rather than a clinical decision trigger.
• Recognizing Bandl's ring is a critical nursing skill in labor and delivery. It is an obstetric emergency that requires immediate intervention to prevent maternal and fetal death.
• The nurse's primary responsibility upon identifying a suspected Bandl's ring is to stop any oxytocin infusion immediately and urgently notify the obstetrician or senior medical staff.
• The team must prepare for an emergency Cesarean section. The nurse plays a key role in preparing the patient, ensuring IV access, and monitoring maternal and fetal vital signs continuously.

How to Approach the Question

• First, analyze the patient's history: 41 weeks, G1P0, and a history of previous LSCS. The LSCS history is a major risk factor for uterine rupture.
• Next, identify the key clinical finding described: a 'pathological grove ring' and 'horizontal ridge across the abdomen' during labor.
• Correlate this finding with the clinical context. A ridge forming on the uterus during obstructed labor is a classic sign.
• Evaluate the options. 'Bandl's ring' is the specific medical term for this pathological retraction ring.
• Eliminate the other options. 'Uterus rupture' is the potential outcome, not the sign itself. 'Hegar's sign' is an early pregnancy sign. 'Uterus atrophy' is a postmenopausal change.
• Conclude that the finding described is Bandl's ring, a critical indicator of impending uterine rupture.

Concept Tested & Keywords

• Concept Tested: The question tests the knowledge of clinical signs associated with obstructed labor, specifically the identification of a pathological retraction ring.
• Stem keywords: 41-week pregnant, labor, pathological grove ring, horizontal ridge, previous LSCS
• Lead-in keywords: What is this finding called?
• Clinical cues: [object Object]

Question ID

QxDkiGTS5MY5Y_55IlVoMZ

Copy ID