EMQ — Extended Matching Question · Review
Question 208
Delivery suite → Haemorrhage
Classification
Question
EEMQAnswer Bank
Correct Answer
Explanation
When APH occurs in close temporal association with spontaneous or artificial rupture of membranes, ruptured vasa praevia should be considered, particularly when maternal condition remains stable while the fetus deteriorates rapidly. The bleeding may be fetal rather than maternal.
Option Validity
A) Placental abruption may compromise the fetus but the soft non-tender uterus and immediate relationship to membrane rupture point elsewhere.
B) Placenta praevia causes maternal bleeding and does not characteristically produce this disproportionate acute fetal deterioration after membrane rupture.
D) Cervical ectropion does not explain rapid fetal compromise immediately after rupture of membranes.
E) Cervical malignancy does not fit the abrupt membrane-rupture-related presentation.
F) A show does not cause rapid fetal deterioration.
G) Vaginal trauma is not suggested and would not explain the characteristic timing.
H) The haemorrhage should not remain unexplained when the membrane-rupture relationship strongly suggests vasa praevia.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.