EMQ

EMQ — Extended Matching Question · Review

Question 264

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

General

Subtopic 3

Unexplained APH pregnancy risk

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 32-year-old G2P0 at 27+6 weeks has a moderate episode of APH. Placenta praevia, obvious cervical pathology and a clinically convincing abruption are not identified. Bleeding stops and fetal assessment is reassuring. She is relieved that no cause has been found and asks whether this means the remainder of the pregnancy carries the same risk profile as a pregnancy in which APH never occurred.

Answer Bank

A Unexplained APH is benign once the acute bleeding stops

B Unexplained APH is associated with increased risks of adverse pregnancy outcomes, including preterm delivery and stillbirth

C The only recognised subsequent risk is recurrent maternal anaemia

D Risk is increased only if placenta praevia is subsequently diagnosed

E Unexplained APH affects maternal outcomes but has no recognised fetal association

F Adverse outcomes occur only after massive APH with shock

G Prognosis is identical to an unaffected pregnancy when ultrasound is normal

H Subsequent risk is confined to congenital anomaly and excludes preterm birth

Correct Answer

B. Unexplained APH is associated with increased risks of adverse pregnancy outcomes, including preterm delivery and stillbirth

Explanation

Failure to identify a specific cause does not make APH prognostically irrelevant. Unexplained APH has been associated with increased risks of adverse pregnancy outcomes, including preterm delivery, stillbirth and other neonatal morbidity. This evidence supports recognising such pregnancies as higher risk and planning subsequent surveillance accordingly rather than offering false reassurance based solely on the absence of a definitive diagnosis.

Option Validity

A) Resolution of bleeding does not abolish the recognised subsequent risks associated with unexplained APH.

C) The implications extend beyond maternal anaemia.

D) Increased risk has been reported in unexplained APH itself and does not depend on later diagnosis of placenta praevia.

E) Fetal and neonatal adverse outcomes are part of the recognised association.

F) Adverse outcome associations are not confined to massive haemorrhage with shock.

G) Normal imaging does not make prognosis identical to that of a pregnancy without APH.

H) Preterm delivery is among the important recognised adverse outcomes.

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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