EMQ

EMQ — Extended Matching Question · Review

Question 261

Delivery suite → Haemorrhage

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Type EEMQ

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Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

General

Subtopic 3

RhD-negative anti-D prophylaxis

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 28-year-old G2P1 at 30+2 weeks, known to be RhD negative and not sensitised, presents with a moderate APH that settles after admission. Maternal observations and fetal assessment are reassuring. The cause remains unexplained. She received routine antenatal anti-D prophylaxis recently and asks whether the current bleeding episode has any additional implication for rhesus prophylaxis.

Answer Bank

A Treat the APH as a potentially sensitising event and provide appropriate anti-D prophylaxis in accordance with the relevant regimen

B No anti-D is required after APH once routine antenatal prophylaxis has been given

C Anti-D is required only when placental abruption is proven by ultrasound

D Anti-D is required only after major haemorrhage exceeding 1000 mL

E Anti-D should be withheld if fetal assessment is normal

F Anti-D is indicated only after delivery

G Unexplained APH cannot cause fetomaternal haemorrhage

H Anti-D is relevant only before 24 weeks

Correct Answer

A. Treat the APH as a potentially sensitising event and provide appropriate anti-D prophylaxis in accordance with the relevant regimen

Explanation

Antepartum haemorrhage is a potentially sensitising event in a non-sensitised RhD-negative woman. Appropriate anti-D prophylaxis should therefore be considered following the bleeding episode according to the applicable regimen. Routine antenatal prophylaxis does not mean that subsequent potentially sensitising events can simply be ignored.

Option Validity

B) Routine antenatal prophylaxis does not remove the need to address subsequent potentially sensitising events appropriately.

C) Anti-D management does not require ultrasound confirmation of placental abruption.

D) Sensitisation risk is not restricted to haemorrhage exceeding one litre.

E) Reassuring fetal assessment does not remove the maternal rhesus-sensitisation issue.

F) Potentially sensitising antenatal events require consideration at the time they occur.

G) Unexplained APH may still be associated with fetomaternal haemorrhage.

H) Rhesus prophylaxis remains relevant to APH occurring after 24 weeks.

Source & metrics

Authored Difficulty

4.00

Evaluation Score

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Destination

eBook

Source

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Source Section

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Source Locator

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Updated

2026-10-06 01:57:35

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