USMLE Step 2 CK Lecture Notes 2019: Obstetrics/Gynecology (Kaplan Test Prep)

OB TRIAD

Low Transverse  Uterine Incision

Low risk    of  rupture (0.5%   in  labor)

Less    blood   loss    and adhesions

Safe    for subsequent  labor   trial

Classical. This incision is made in the contractile fundus of the uterus and is
less commonly performed. Technically it is easy to perform, and no bladder
dissection is needed. Risk of uterine rupture both before labor as well as in
subsequent labor is significant (5%). Repeat cesarean should be scheduled
before labor onset.
Advantages are any fetus(es) regardless of intrauterine orientation can
be delivered; lower segment varicosities or myomas can be bypassed.
Disadvantages are trial of labor in a subsequent pregnancy is unsafe; the
risk of bleeding and adhesions is higher.