EMQ — Extended Matching Question · Review
Question 214
Delivery suite → Haemorrhage
Classification
Question
EEMQAnswer Bank
Correct Answer
Explanation
This requires integration rather than reliance on measured external blood loss or ultrasound. Trauma is a recognised association with placental abruption, haemorrhage may be concealed, and ultrasound has limited sensitivity for abruption. The combination of trauma, increasing pain, uterine tenderness and fetal compromise should therefore carry greater diagnostic weight.
Option Validity
B) Placenta praevia does not explain the post-traumatic painful tender uterus and fetal deterioration.
C) Vasa praevia is principally suggested by bleeding around membrane rupture with disproportionate fetal compromise.
D) Cervical ectropion cannot account for the uterine findings and fetal compromise.
E) Cervical malignancy does not fit this acute post-traumatic presentation.
F) Labour-related show does not explain persistent uterine tenderness and fetal compromise after trauma.
G) A superficial vaginal injury could cause visible blood but would not explain the uterine and fetal findings.
H) The haemorrhage should not be called unexplained when the clinical constellation strongly supports abruption.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.