EMQ

EMQ — Extended Matching Question · Review

Question 251

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

Placental abruption

Subtopic 3

Risk assessment

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 27-year-old G2P1 at 32+6 weeks presents with abdominal pain and vaginal bleeding. She initially reports that she walked into a door earlier that day. During private review away from her partner, she becomes tearful and discloses repeated blows to the abdomen during pregnancy. Her pulse is 104/min, the uterus is tender and fetal monitoring is commenced. The clinician considers the significance of trauma and domestic violence when assessing the possibility of placental abruption.

Answer Bank

A Trauma is relevant only if a maternal fracture is demonstrated

B Domestic violence has no recognised relationship with placental abruption

C Trauma becomes relevant only after 37 weeks

D Abdominal trauma is associated only with placenta praevia

E Trauma can be disregarded if the visible vaginal bleeding is small

F Abruption following trauma requires ultrasound confirmation before the history is considered relevant

G Domestic violence is relevant only to safeguarding and not to the obstetric differential diagnosis

H Abdominal trauma, including trauma associated with domestic violence, is a recognised risk factor for placental abruption

Correct Answer

H. Abdominal trauma, including trauma associated with domestic violence, is a recognised risk factor for placental abruption

Explanation

Abdominal trauma is a recognised risk factor for placental abruption, and domestic violence is specifically important because it may involve repeated or concealed abdominal trauma. The disclosure therefore has both safeguarding and immediate obstetric significance. In a woman with abdominal pain, bleeding and uterine tenderness, it strengthens concern for abruption while appropriate maternal and fetal assessment proceeds.

Option Validity

A) Significant placental injury may occur without maternal fracture.

B) Domestic violence involving abdominal trauma is relevant to the risk of abruption.

C) Trauma can precipitate placental abruption before term.

D) Abdominal trauma is particularly relevant to placental separation rather than being restricted to placenta praevia.

E) Visible loss may underestimate haemorrhage in abruption.

F) Abruption is a clinical diagnosis and negative imaging would not eliminate the relevance of the trauma history.

G) Domestic violence has important safeguarding implications but can simultaneously alter the obstetric differential diagnosis.

Source & metrics

Authored Difficulty

4.00

Evaluation Score

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Destination

eBook

Source

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Updated

2026-10-06 01:57:35

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