A 40-year-old multigravida with multiple fibroids in the lower segment of the uterus in the 3rd trimester. Most appropriate in this case would be?

If a cesarean hysterectomy is planned, the best abdominal entry technique is via midline vertical incision. This allows retractor placement and optimizes exposure to nearby organs and may facilitate access to the upper abdomen. This incision is in general preferable to the Pfannenstiel or low transverse (“bikini cut”) incision most commonly used by obstetricians for cesarean delivery due to the limited exposure afforded by this incision. In rare emergent circumstances, a low transverse incision may need to be converted to a midline vertical incision to enhance exposure, resulting in an inverted T-shaped incision, which is more difficult to close, more painful, less cosmetically acceptable, and may result in a longer recovery time.