EMQ

EMQ — Extended Matching Question · Review

Question 279

Delivery suite → Haemorrhage

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Type EEMQ

UUID 65d0b76a-3a14-4c3d-9040-66f068374bd3

Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

General

Subtopic 3

Spotting discharge assessment

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 33-year-old G3P2 at 35+6 weeks notices a single streak of blood on wiping after intercourse. There is no further bleeding. Maternal observations are normal, the abdomen is soft and non-tender, fetal movements are normal and fetal assessment is reassuring. Ultrasound documentation confirms that the placenta is clear of the cervical os. Speculum examination shows a small cervical ectropion with no active bleeding. She lives close to the maternity unit, has transport and understands the instructions for returning urgently.

Answer Bank

A Admit until delivery because all APH requires prolonged hospitalisation

B Discharge may be appropriate after reassuring assessment, with clear advice to return if bleeding recurs

C Perform emergency caesarean birth because any APH after 34 weeks requires delivery

D Commence major-haemorrhage transfusion protocol

E Keep inpatient until haemoglobin has fallen and recovered

F Perform digital vaginal examination repeatedly before discharge

G Arrange daily ultrasound until birth

H Diagnose placental abruption despite the reassuring clinical assessment

Correct Answer

B. Discharge may be appropriate after reassuring assessment, with clear advice to return if bleeding recurs

Explanation

A woman with only spotting, no continuing haemorrhage, reassuring maternal and fetal assessment and an identified benign local explanation may be suitable for discharge after appropriate assessment. Disposition should nevertheless be individualised, including the woman's ability to return promptly if bleeding recurs. APH does not create an automatic requirement for admission until delivery.

Option Validity

A) Not every episode of resolved spotting requires admission until birth.

C) A small resolved episode with reassuring assessment does not itself mandate delivery.

D) There is no evidence of major maternal haemorrhage requiring transfusion activation.

E) Discharge does not require development and subsequent correction of anaemia.

F) Repeated digital examination has no role in establishing suitability for discharge in this scenario.

G) Daily ultrasound is not routinely required after an isolated resolved episode with reassuring assessment.

H) The clinical findings do not justify diagnosing abruption in the absence of supportive features.

Source & metrics

Authored Difficulty

4.00

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Updated

2026-10-06 01:57:35

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