EMQ — Extended Matching Question · Review
Question 219
Delivery suite → Haemorrhage
Classification
Question
EEMQQuestion Header
Select the single most appropriate interpretation of the investigation result.
Question Stem
A normal ultrasound excludes clinically significant abruption
Answer Bank
A
A normal ultrasound excludes clinically significant abruption
B
Ultrasound sensitivity is sufficient to replace clinical assessment
C
Abruption is excluded if placental location is normal
D
A normal CTG excludes maternal placental separation
E
Absence of vaginal bleeding excludes abruption
F
A normal coagulation screen excludes abruption
G
A normal haemoglobin excludes major acute haemorrhage
H
A negative ultrasound does not exclude placental abruption; the diagnosis remains principally clinical
Correct Answer
H. A negative ultrasound does not exclude placental abruption; the diagnosis remains principally clinical
Explanation
Ultrasound is useful for establishing placental location and diagnosing placenta praevia, but its sensitivity for placental abruption is limited. A negative scan therefore cannot exclude abruption. Clinical features including pain, uterine tenderness or hypertonicity, maternal condition and fetal status remain central to diagnosis.
Option Validity
A) A normal ultrasound cannot reliably exclude abruption.
B) Ultrasound complements rather than replaces clinical assessment.
C) A normally located placenta does not exclude premature placental separation.
D) A reassuring CTG does not prove that placental separation has not occurred.
E) Abruption may be concealed with little or no external bleeding.
F) Coagulation results assess complications rather than exclude the diagnosis.
G) 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.