EMQ

EMQ — Extended Matching Question · Review

Question 278

Delivery suite → Haemorrhage

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Type EEMQ

UUID 07abb579-ff9b-405e-836f-0fe475d82771

Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

General

Subtopic 3

Antenatal corticosteroids preterm APH

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 29-year-old G2P1 at 30+4 weeks presents with approximately 80 mL of fresh vaginal bleeding. Placenta praevia has been excluded. Maternal observations are normal, the uterus is soft and non-tender and CTG is reassuring. The bleeding has now settled. There is no established labour, but the obstetric team considers that the APH increases the possibility that preterm birth may subsequently become necessary.

Answer Bank

A Corticosteroids are contraindicated after any APH

B Corticosteroids should be delayed until labour is established

C Corticosteroids are indicated only if placental abruption is proven by ultrasound

D Corticosteroids should be reserved for pregnancies below 28 weeks

E Corticosteroids should be given only after recurrent APH

F Offer a course of antenatal corticosteroids because preterm birth remains a clinically relevant possibility

G Give corticosteroids only if the haemoglobin falls

H Corticosteroids are unnecessary because the bleeding has stopped

Correct Answer

F. Offer a course of antenatal corticosteroids because preterm birth remains a clinically relevant possibility

Explanation

In a preterm pregnancy complicated by APH, the possibility of subsequent preterm delivery should be considered even when the immediate bleeding settles and fetal assessment is reassuring. Where there is a clinically relevant risk of preterm birth, antenatal corticosteroids should be offered in accordance with gestational-age recommendations. Resolution of the initial haemorrhage does not itself remove the potential neonatal benefit.

Option Validity

A) APH is not itself a contraindication to antenatal corticosteroids.

B) Treatment should not necessarily await established labour when preterm delivery is considered possible.

C) Ultrasound confirmation of placental abruption is not required before corticosteroids can be considered.

D) The potential indication is not confined to pregnancies below 28 weeks.

E) A first clinically significant APH may be sufficient to create concern about preterm birth.

G) Maternal haemoglobin concentration does not determine fetal pulmonary benefit from corticosteroids.

H) Cessation of bleeding does not eliminate the possibility of subsequent preterm delivery.

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Updated

2026-10-06 01:57:35

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