Because we should all be precise with the nomenclature that we use, I want to bring attention to the article by Greenwald et al, in that the authors use the term dehiscence in the title, yet they use the term asymptomatic second-trimester rupture in the text. Gynecologists well know that the clinical situation in which a patient has a uterine rupture, the patient commonly exhibits signs of intraabdominal hemorrhage, often with hypotension, tachycardia, and rebound abdominal tenderness. In contrast, however, when a dehiscence is seen in a patient (or a uterine window, as it is sometimes called), typically at the time of a repeat cesarean delivery, it is not too disturbing a finding because the patient is virtually always asymptomatic.

Using these terms interchangeably may be confusing to the reader, although these terms have been previously defined. We may need to pay special attention to uterine rupture (and its associated risk factors, such as a vaginal trial of labor), whereas the identification of a uterine window is typically not clinically apparent and does not require any special emergency attention. Because the integrity of the uterine wall may be relevant to the choice for a vaginal trial of labor, it has been suggested that sonographic assessment could be considered.

It is my opinion that semantics are very important.