EMQ — Extended Matching Question · Review
Question 262
Delivery suite → Haemorrhage
Classification
Question
EEMQQuestion Header
Select the single most appropriate purpose of fetomaternal haemorrhage testing in this setting.
Question Stem
A 34-year-old G3P1 at 35 weeks is RhD negative and not sensitised. She presents with significant APH and receives anti-D prophylaxis. The team arranges testing to quantify fetomaternal haemorrhage. A trainee assumes that the purpose of the test is to determine whether placental abruption caused the bleeding and proposes cancelling it because ultrasound shows no retroplacental clot.
Answer Bank
A
To diagnose placenta praevia
B
To determine whether the cervix is the source of bleeding
C
To quantify maternal blood loss
D
To decide whether fetal monitoring is necessary
E
To exclude placental abruption when ultrasound is negative
F
To measure maternal coagulation-factor consumption
G
To determine fetal presentation
H
To assess the magnitude of fetomaternal haemorrhage and inform whether additional anti-D is required
Correct Answer
H. To assess the magnitude of fetomaternal haemorrhage and inform whether additional anti-D is required
Explanation
In an RhD-negative, non-sensitised woman with APH, assessment of fetomaternal haemorrhage may be required to determine whether the standard anti-D dose provides adequate coverage or whether additional anti-D is necessary. The test is not a diagnostic investigation for placental abruption and should not be interpreted as such.
Option Validity
A) Fetomaternal haemorrhage testing does not localise the placenta.
B) It does not identify cervical pathology.
C) It does not quantify maternal haemorrhage.
D) The need for fetal assessment is determined clinically, not by this test.
E) The test neither confirms nor excludes placental abruption.
F) Coagulation abnormalities require appropriate haemostatic laboratory testing.
G) Fetal presentation is determined clinically or by imaging, not fetomaternal haemorrhage testing.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.