EMQ — Extended Matching Question · Review
Question 212
Delivery suite → Haemorrhage
Classification
Question
EEMQAnswer Bank
Correct Answer
Explanation
Speculum examination may identify a local genital-tract source of APH. In this scenario the temporal relationship to trauma and direct visualisation of an actively bleeding superficial vaginal laceration make vaginal trauma the most likely source, while appropriate maternal and fetal assessment remains necessary.
Option Validity
A) Placental abruption is not supported by the absence of abdominal pain, tenderness or fetal compromise and by demonstration of a local bleeding lesion.
B) Placenta praevia is not supported by the normal placental location.
C) Vasa praevia is not suggested without bleeding related to membrane rupture or fetal deterioration.
D) Cervical ectropion is not the demonstrated source because the bleeding lesion is vaginal.
E) Cervical malignancy is not supported by the examination findings.
F) Labour-related show is not consistent with active bleeding from a visualised vaginal laceration.
H) The haemorrhage is not unexplained because a specific local source has been demonstrated.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.