EMQ

EMQ — Extended Matching Question · Review

Question 243

Delivery suite → Haemorrhage

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Type EEMQ

UUID 10310951-4bc3-4ff0-a60e-5d3ad6ca7b3d

Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

Local

Subtopic 3

Cervical pathology

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 34-year-old G2P1 at 29+5 weeks reports three episodes of painless postcoital bleeding over six weeks. Placental localisation is normal and fetal assessment is reassuring. She is haemodynamically stable and has no abdominal pain or uterine tenderness. Speculum examination demonstrates an irregular friable cervical lesion that bleeds on contact and does not have the typical appearance of simple ectropion. Her most recent cervical screening history is incomplete because she moved between healthcare systems shortly before pregnancy.

Answer Bank

A Reassure her that all cervical contact bleeding in pregnancy represents ectropion

B Ignore the lesion until six weeks postpartum

C Treat empirically as cervicitis without further assessment

D Arrange appropriate colposcopic evaluation of the suspicious cervix

E Perform immediate digital cervical examination repeatedly to assess the lesion

F Diagnose placenta praevia despite normal placental localisation

G Diagnose placental abruption because any APH after 24 weeks should be considered abruption

H Discharge without follow-up once fetal assessment is reassuring

Correct Answer

D. Arrange appropriate colposcopic evaluation of the suspicious cervix

Explanation

APH may arise from local genital-tract pathology. A suspicious cervical lesion identified during appropriate examination should not automatically be attributed to benign pregnancy-related cervical change. Colposcopic evaluation is appropriate. The reassuring fetal assessment and normal placental location help narrow the immediate obstetric differential but do not remove the need to investigate clinically suspicious cervical pathology.

Option Validity

A) Although ectropion is a common benign source of contact bleeding, a suspicious irregular lesion requires further evaluation.

B) Deferring all assessment until postpartum risks delaying evaluation of significant cervical pathology.

C) Empirical treatment does not adequately evaluate a suspicious lesion.

E) Repeated digital examination is not the appropriate diagnostic approach to a visible suspicious cervical lesion.

F) Normal placental localisation makes placenta praevia an inappropriate explanation for the cervical lesion.

G) APH has several causes and should not automatically be labelled placental abruption.

H) Reassuring fetal status does not resolve the maternal cervical abnormality.

Source & metrics

Authored Difficulty

4.00

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Updated

2026-10-06 01:57:35

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