EMQ — Extended Matching Question · Review
Question 216
Delivery suite → Haemorrhage
Classification
Question
EEMQAnswer Bank
Correct Answer
Explanation
Major or massive APH requires investigation appropriate to significant haemorrhage, including full blood count, coagulation studies, crossmatching of four units of blood and biochemical assessment with urea/electrolytes and liver function tests. Initial haemoglobin may not reflect the true magnitude of acute blood loss, so investigation and resuscitation must be driven by the clinical situation rather than waiting for anaemia to become apparent.
Option Validity
A) Normal observations do not remove the need for appropriate investigation in significant APH.
B) Ultrasound cannot quantify maternal physiological impact and cannot exclude placental abruption.
C) Full blood count alone is inadequate for major or massive haemorrhage.
E) Kleihauer testing has a specific role in assessing fetomaternal haemorrhage for anti-D dosing, not as the principal haemorrhage investigation.
F) CT is not the routine investigation strategy for obstetric APH.
G) Coagulation testing alone omits essential haematological, crossmatch and biochemical assessment.
H) Initial haemoglobin may not accurately reflect acute blood loss.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.