EMQ

EMQ — Extended Matching Question · Review

Question 281

Delivery suite → Haemorrhage

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Type EEMQ

UUID 4cfb39c1-e416-4303-ba7a-c3d2bd90e2ad

Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

General

Subtopic 3

Unexplained APH timing of delivery

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 34-year-old G2P1 had two episodes of unexplained APH at 32 and 34 weeks. Placenta praevia was excluded and there has been no further bleeding. Serial fetal growth assessment has remained satisfactory. At 37+2 weeks she is asymptomatic, maternal observations are normal and fetal assessment is reassuring. She asks whether the previous unexplained bleeding creates a mandatory requirement for immediate induction today.

Answer Bank

A Immediate caesarean birth is mandatory after any unexplained APH

B Pregnancy must continue to 42 weeks because the bleeding has stopped

C Delivery is mandatory exactly seven days after the last APH

D After unexplained APH without maternal or fetal compromise, timing of delivery should be individualised rather than dictated by a universal gestational threshold

E Delivery must occur before 34 weeks whenever APH recurs

F Previous APH has no relevance to subsequent delivery planning

G Induction is contraindicated after unexplained APH

H Delivery timing should depend only on the original measured blood loss

Correct Answer

D. After unexplained APH without maternal or fetal compromise, timing of delivery should be individualised rather than dictated by a universal gestational threshold

Explanation

When APH has been unexplained and there is no continuing maternal or fetal compromise, there is no single mandatory gestation at which every woman must be delivered. Previous bleeding remains relevant to risk and planning, but timing and mode of birth should be individualised according to the complete clinical situation.

Option Validity

A) Previous unexplained APH alone does not mandate caesarean birth.

B) There is no requirement to continue every such pregnancy to 42 weeks.

C) No fixed interval from the last bleed determines delivery.

E) Recurrent APH does not automatically require delivery before 34 weeks when maternal and fetal conditions remain reassuring.

F) Previous APH remains relevant to subsequent obstetric risk and planning.

G) Induction is not universally contraindicated solely because APH occurred earlier in pregnancy.

H) Delivery planning requires more than the measured volume of the original haemorrhage.

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Updated

2026-10-06 01:57:35

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