EMQ — Extended Matching Question · Review
Question 254
Delivery suite → Haemorrhage
Classification
Question
EEMQQuestion Header
Select the single most appropriate interpretation of her previous obstetric history.
Question Stem
A 35-year-old G4P2 attends for antenatal review at 18 weeks. Her previous pregnancy was complicated by placenta praevia. She has also had one previous caesarean birth. In the current pregnancy she is asymptomatic and has not yet had formal placental localisation at the anomaly scan. She asks whether the previous placenta praevia has any bearing on the probability of the condition recurring.
Answer Bank
A
Previous placenta praevia is a recognised risk factor for placenta praevia in a subsequent pregnancy
B
Previous placenta praevia protects against recurrence because the implantation site changes
C
Recurrence risk is increased only after three or more previous caesarean births
D
Previous placenta praevia predicts placental abruption but not recurrent praevia
E
The previous history becomes relevant only if bleeding occurs after 24 weeks
F
Placenta praevia has no recognised recurrence tendency
G
Maternal age is the only relevant factor in this history
H
Previous placenta praevia is relevant only when the current fetus is non-cephalic
Correct Answer
A. Previous placenta praevia is a recognised risk factor for placenta praevia in a subsequent pregnancy
Explanation
Previous placenta praevia is itself a recognised risk factor for placenta praevia in a subsequent pregnancy. Her previous caesarean birth adds further relevant risk. The history therefore has value before any bleeding occurs and should inform awareness when placental localisation is assessed during the current pregnancy. A previous event is not determinative, but it modifies prior probability.
Option Validity
B) Previous placenta praevia increases rather than protects against recurrence.
C) Risk is not restricted to women with three or more previous caesarean births.
D) Previous placenta praevia is directly relevant to recurrent placenta praevia.
E) Risk assessment is relevant before the development of APH.
F) Recurrence is a recognised clinical association.
G) Maternal age may contribute to risk but is not the only relevant feature here.
H) The recurrence association does not depend on fetal presentation.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.