EMQ — Extended Matching Question · Review
Question 217
Delivery suite → Haemorrhage
Classification
Question
EEMQQuestion Header
Select the single most appropriate immediate management principle.
Question Stem
Delay treatment until the cause of bleeding is established
Answer Bank
A
Delay treatment until the cause of bleeding is established
B
Perform ultrasound before commencing resuscitation
C
Use visible blood loss as the sole guide to severity
D
Await the full blood count before obtaining intravenous access
E
Transfer for imaging before stabilisation
F
Prioritise fetal assessment over maternal resuscitation
G
Resuscitate the mother immediately while assessment and diagnosis proceed in parallel
H
Observe until maternal hypotension develops
Correct Answer
G. Resuscitate the mother immediately while assessment and diagnosis proceed in parallel
Explanation
In major or massive APH, maternal resuscitation is the immediate priority. Assessment of the cause, fetal condition and definitive obstetric management should proceed concurrently rather than delaying restoration of maternal circulating volume and physiological stability. Visible bleeding may underestimate total blood loss, particularly with concealed abruption.
Option Validity
A) Establishing the exact cause must not delay treatment of significant haemorrhage.
B) Ultrasound must not precede necessary maternal resuscitation.
C) Visible loss can underestimate haemorrhage, particularly when bleeding is concealed.
D) Resuscitation should not wait for laboratory results.
E) A woman requiring stabilisation should be assessed and resuscitated before transfer.
F) Maternal resuscitation is the immediate priority and also supports fetal wellbeing.
H) Waiting for hypotension risks allowing compensated shock to progress.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.