EMQ — Extended Matching Question · Review
Question 224
Delivery suite → Haemorrhage
Classification
Question
EEMQQuestion Header
Select the single most appropriate interpretation of haemorrhage severity.
Question Stem
Visible blood loss precisely represents total blood loss
Answer Bank
A
Visible blood loss precisely represents total blood loss
B
Maternal tachycardia is irrelevant if blood pressure is normal
C
A normal initial haemoglobin reliably excludes severe haemorrhage
D
Clinical assessment of maternal condition is more important than relying on visible blood-loss volume alone
E
Concealed haemorrhage occurs only after rupture of membranes
F
Fetal compromise cannot occur when visible bleeding is minor
G
Ultrasound measurement of a clot accurately quantifies total blood loss
H
Severity classification should be postponed until laboratory results are available
Correct Answer
D. Clinical assessment of maternal condition is more important than relying on visible blood-loss volume alone
Explanation
The apparent volume of vaginal bleeding may underestimate total haemorrhage because bleeding can be concealed, particularly with placental abruption. Acute haemorrhage may also precede a significant fall in haemoglobin. Maternal physiological assessment and the overall clinical picture are therefore fundamental when judging severity.
Option Validity
A) External bleeding may substantially underestimate total haemorrhage.
B) Tachycardia may be an important early physiological sign of blood loss.
C) Initial haemoglobin may not reflect the severity of acute haemorrhage.
E) Concealed haemorrhage is particularly associated with abruption and is not dependent on membrane rupture.
F) Fetal compromise can occur despite apparently limited external bleeding.
G) Ultrasound cannot reliably quantify total haemorrhage.
H) Clinical severity must be assessed immediately rather than waiting for laboratory results.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.