Which type of incision is done in classical caesarean section?

Appeared in: BSF Staff Nurse - 2015

Explanation

A classical caesarean section is defined by a vertical incision made in the upper, contractile portion of the uterus (corpus uteri).
This approach provides rapid access to the fetus but is associated with higher risks compared to lower segment incisions, including increased blood loss and a weaker scar.
The incision is made through the thickest part of the uterine muscle, which contracts forcefully during labor, leading to a significantly higher risk of uterine rupture in subsequent pregnancies.

Option A: This describes a low vertical incision. While it is a vertical cut, its location in the lower uterine segment distinguishes it from the classical type.
Option B: This is the most common type of caesarean incision performed today, known as the Kerr incision. It is the modern standard, not the classical method.
Option D: A transverse incision in the upper uterine segment is not a standard surgical procedure.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Types of uterine incisions for caesarean section as background academic context rather than a clinical decision trigger.
A history of a classical C-section is a critical piece of information for future pregnancies, as it contraindicates a trial of labor after caesarean (TOLAC) or vaginal birth after caesarean (VBAC).
The primary nursing concern for a patient with a prior classical C-section is the significantly increased risk of uterine rupture, which is a life-threatening emergency for both mother and fetus.
What if? If a patient has a low transverse incision from a prior C-section, she may be a candidate for a vaginal birth after caesarean (VBAC), provided there are no other contraindications. This is a key difference in long-term management compared to a classical incision.

How to Approach the Question

First, identify the key terms in the question: 'classical caesarean section' and 'incision'.
Recognize that this is a factual recall question requiring knowledge of different surgical procedures.
Recall the definition of a 'classical' C-section, which refers to the original or historical method, as opposed to the modern standard.
Differentiate this from the more common 'low transverse' incision by considering both the location (upper vs. lower uterine segment) and the direction (vertical vs. transverse) of the cut.
Evaluate the options to find the one that matches the definition of a classical caesarean incision: a vertical cut in the upper segment of the uterus.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 57-76

Practise the full BSF Staff Nurse - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.