EMQ

EMQ — Extended Matching Question · Review

Question 238

Delivery suite → Haemorrhage

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Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

Placenta praevia

Subtopic 3

Risk assessment

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 41-year-old G6P4 presents at 22 weeks for review after the anomaly scan identifies a low-lying placenta. She has had three previous caesarean births, one surgical termination of pregnancy and conception of the current pregnancy following assisted reproductive treatment. She smokes five cigarettes daily. She asks why placental localisation later in pregnancy is particularly important in her case. The clinician reviews the factors associated with placenta praevia rather than assuming that the ultrasound finding is an isolated event.

Answer Bank

A Her risk is increased only because she is older than 40 years

B Her risk is increased only by assisted reproductive treatment

C Previous caesarean birth, multiparity, advanced maternal age and assisted conception are among recognised associations with placenta praevia

D Smoking protects against persistence of a low-lying placenta

E Previous uterine procedures are unrelated to placenta praevia

F Her risk profile is more characteristic of placental abruption than placenta praevia

G Placenta praevia has no recognised association with previous caesarean birth

H The number of previous pregnancies has no relevance to placenta praevia risk

Correct Answer

C. Previous caesarean birth, multiparity, advanced maternal age and assisted conception are among recognised associations with placenta praevia

Explanation

This woman has several recognised associations with placenta praevia, including previous caesarean birth, multiparity, advanced maternal age and assisted conception. Previous uterine instrumentation and endometrial damage are also relevant considerations. The educational point is cumulative risk recognition: a sophisticated assessment should integrate multiple elements of the obstetric and reproductive history rather than attributing risk to a single feature.

Option Validity

A) Advanced maternal age contributes to risk but is not the only relevant factor.

B) Assisted conception is associated with placenta praevia but does not account for the whole risk profile.

D) Smoking is not a protective feature in this context.

E) Previous uterine procedures and endometrial damage are recognised associations.

F) Although some factors may overlap between obstetric disorders, the combination presented contains multiple established associations with placenta praevia.

G) Previous caesarean birth is an important recognised risk factor for placenta praevia.

H) Multiparity is among the recognised associations with placenta praevia.

Source & metrics

Authored Difficulty

4.00

Evaluation Score

—

Destination

eBook

Source

—

Source Section

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Source Locator

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Updated

2026-10-06 01:57:35

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