EMQ

EMQ — Extended Matching Question · Review

Question 263

Delivery suite → Haemorrhage

Review Question Previous Next

NextGen Workflow Status Needs Review

SQL status generated

Destination Site

Type EEMQ

UUID 81f11e28-30ec-4992-af4c-d23d338cd565

Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

General

Subtopic 3

Unexplained APH fetal growth surveillance

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 30-year-old primigravida has been admitted at 29+4 weeks with a moderate APH. Placenta praevia and obvious local pathology are excluded, there are no convincing clinical features of abruption, and the bleeding settles. Maternal and fetal assessments are reassuring at discharge. At follow-up she asks whether, because no cause was found and the bleeding has stopped, she can return immediately to routine low-risk antenatal surveillance without additional fetal assessment.

Answer Bank

A Return to routine care because unexplained APH has no association with impaired fetal growth

B Arrange no further fetal assessment unless another visible bleed occurs

C Schedule elective delivery at 32 weeks regardless of subsequent findings

D Recognise the pregnancy as higher risk after unexplained APH and include appropriate surveillance of fetal growth

E Perform daily ultrasound until delivery

F Arrange invasive fetal testing because the APH was unexplained

G Restrict surveillance to maternal haemoglobin measurements

H Use fetal movement counting as the sole additional surveillance strategy

Correct Answer

D. Recognise the pregnancy as higher risk after unexplained APH and include appropriate surveillance of fetal growth

Explanation

Unexplained APH is associated with adverse pregnancy outcomes, including preterm birth and impaired fetal growth. Following an unexplained episode, the pregnancy should therefore not automatically revert to an uncomplicated low-risk pathway. Appropriate subsequent surveillance should include assessment of fetal growth, with the intensity of care tailored to the clinical course.

Option Validity

A) Unexplained APH is associated with adverse outcomes and does not automatically permit return to entirely routine surveillance.

B) The absence of recurrent visible bleeding does not eliminate the rationale for subsequent growth surveillance.

C) Unexplained APH alone does not mandate very-preterm elective delivery.

E) Daily ultrasound is not routinely required.

F) Lack of an identified bleeding source is not itself an indication for invasive fetal testing.

G) Maternal haemoglobin surveillance does not address fetal growth risk.

H) Fetal movement awareness does not replace appropriate objective growth surveillance.

Source & metrics

Authored Difficulty

4.00

Evaluation Score

—

Destination

Site

Source

—

Source Section

—

Source Locator

—

Updated

2026-10-06 01:57:35

Difficulty Factor

Not available yet

Attended Users

No candidate-attempt data yet