EMQ

EMQ — Extended Matching Question · Review

Question 245

Delivery suite → Haemorrhage

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Type EEMQ

UUID c153cacb-d016-4fb4-9b12-5dc6abf4a6b7

Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

General

Subtopic 3

Fetal assessment

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 30-year-old G3P1 at 33+1 weeks presents with continuing APH and abdominal discomfort. On arrival she is pale, pulse 124/min and blood pressure 92/56 mmHg. The fetal heart is audible by handheld Doppler. A junior clinician proposes spending several minutes establishing a high-quality continuous fetal heart-rate trace before obtaining large-bore intravenous access because fetal viability has already been demonstrated. Another member of the team argues that fetal assessment should be omitted completely until all maternal investigations and resuscitation are finished.

Answer Bank

A Complete prolonged fetal assessment before beginning maternal resuscitation

B Omit fetal assessment until maternal resuscitation is completely finished

C Perform ultrasound before any maternal intervention

D Base the sequence entirely on the measured volume of vaginal blood loss

E Obtain laboratory results before assessing either maternal or fetal condition

F Prioritise immediate maternal assessment and resuscitation, with appropriate fetal assessment once maternal assessment is underway

G Assess only the fetus because maternal physiological changes are expected in pregnancy

H Delay both maternal and fetal assessment until the cause of APH is established

Correct Answer

F. Prioritise immediate maternal assessment and resuscitation, with appropriate fetal assessment once maternal assessment is underway

Explanation

In significant APH, maternal assessment and resuscitation take immediate priority because maternal stabilisation is fundamental to both maternal and fetal outcome. This does not mean fetal assessment should be unnecessarily postponed until every aspect of maternal treatment is complete. Once maternal assessment and resuscitative measures are underway, fetal wellbeing should be assessed appropriately when the fetus is viable. The correct approach is therefore coordinated parallel care with maternal resuscitation taking priority, rather than sequential delay at either extreme.

Option Validity

A) Prolonged fetal assessment must not delay urgent maternal resuscitation in a haemodynamically compromised woman.

B) Fetal assessment need not await completion of every component of maternal treatment once resuscitation is underway.

C) Ultrasound must not delay immediate maternal assessment and resuscitation.

D) Visible loss may underestimate true haemorrhage and cannot determine the sequence alone.

E) Neither maternal resuscitation nor appropriate fetal assessment should await laboratory results.

G) Maternal physiological deterioration requires urgent direct assessment and cannot be disregarded.

H) Stabilisation and assessment must begin before the precise aetiology is established.

Source & metrics

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4.00

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Updated

2026-10-06 01:57:35

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