EMQ

EMQ — Extended Matching Question · Review

Question 280

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

Ongoing bleeding inpatient care

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 27-year-old primigravida at 32+2 weeks presents with unexplained APH. Approximately 40 mL of blood was initially seen. Maternal observations remain normal, placenta praevia has been excluded and CTG is reassuring. Four hours later there is still fresh blood on the pad and a small continuing trickle is seen on speculum examination without a cervical source. She asks to go home because the total measured loss remains below 50 mL.

Answer Bank

A Discharge because measured loss is below 50 mL

B Discharge if haemoglobin is normal

C Discharge because CTG is reassuring

D Reclassify the episode as spotting regardless of continuing bleeding

E Arrange outpatient review in four weeks without further assessment

F Discharge after giving oral iron

G Delivery is mandatory solely because bleeding persists

H Continue hospital care while bleeding remains ongoing rather than basing discharge solely on measured volume

Correct Answer

H. Continue hospital care while bleeding remains ongoing rather than basing discharge solely on measured volume

Explanation

Ongoing APH should not be treated as equivalent to a completely resolved minor episode merely because the measured volume is small. Continued bleeding creates an evolving clinical situation and warrants ongoing hospital observation and reassessment. Maternal stability and a reassuring CTG are important but do not make persistent bleeding irrelevant.

Option Validity

A) A numerical volume threshold alone should not determine discharge while bleeding continues.

B) A normal haemoglobin does not make persistent APH suitable for automatic discharge.

C) A reassuring CTG assesses current fetal status but does not remove the significance of ongoing bleeding.

D) Continuing fresh bleeding should not be relabelled as trivial spotting simply because the volume is small.

E) Persistent APH requires current reassessment rather than delayed routine follow-up alone.

F) Oral iron does not address the immediate issue of continuing haemorrhage.

G) Continuing small-volume bleeding does not by itself mandate immediate delivery in an otherwise stable preterm pregnancy.

Source & metrics

Authored Difficulty

4.00

Evaluation Score

—

Destination

eBook

Source

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Source Section

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Updated

2026-10-06 01:57:35

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