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Question 103
Delivery suite → Haemorrhage
Classification
Question
SSBAQuestion Header
A woman presents with unexplained vaginal bleeding at 23+5 weeks. Which statement correctly applies the definition of antepartum haemorrhage?
Question Stem
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Options
A
APH begins at 20+0 weeks
B
APH applies only after fetal viability has been individually established
C
APH begins at 28+0 weeks
D
APH is bleeding from or into the genital tract from 24+0 weeks until birth
E
APH refers only to bleeding after the onset of labour
Explanation
RCOG defines antepartum haemorrhage as bleeding from or into the genital tract occurring from 24+0 weeks of pregnancy and before the birth of the baby. Therefore, bleeding at 23+5 weeks falls outside the formal definition of APH, although it still requires appropriate clinical assessment and management. The definition uses a specified gestational threshold rather than an individual assessment of fetal viability.
Option Validity
A) The RCOG APH definition does not begin at 20 weeks.
B) The definition uses a gestational threshold rather than individual viability assessment.
C) The threshold is 24+0 weeks, not 28+0 weeks.
E) APH is not restricted to bleeding after labour begins.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.