EMQ — Extended Matching Question · Review
Question 241
Delivery suite → Haemorrhage
Classification
Question
EEMQAnswer Bank
Correct Answer
Explanation
Major or massive APH requires comprehensive initial laboratory assessment alongside active resuscitation. This includes full blood count and coagulation testing, crossmatching four units of blood, and biochemical assessment including urea and electrolytes and liver function tests. The initial haemoglobin may underestimate acute blood loss, so investigation and preparation for transfusion should be determined by the clinical severity rather than a reassuring haemoglobin result.
Option Validity
A) Full blood count alone is inadequate in major haemorrhage and an initially preserved haemoglobin may be misleading.
B) Group-and-save is insufficient when major haemorrhage creates a foreseeable requirement for urgent transfusion.
C) Coagulation assessment is important but must be accompanied by broader haematological and biochemical investigation and blood preparation.
D) Biochemistry alone does not address anaemia, coagulopathy or transfusion preparation.
E) Investigations and blood preparation should proceed immediately alongside resuscitation.
G) Assessment of fetomaternal haemorrhage does not replace the investigations required for maternal major haemorrhage.
H) Treatment and investigation must not await precise measurement of blood loss.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.