Session 2·OB/GYN·hard
Uterine rupture
Clinical vignette

A 36-year-old G3P2 at 40 weeks in labor (5 hours in) suddenly develops severe abdominal pain and vaginal bleeding. Prior C-sections × 2. Exam: tender uterus, contractions cease, vertex was −1 station 1 hour ago, now −3 station. Fetal HR: late decelerations + absent variability. BP 95/60, HR 110.

Strongest risk factor?