EMQ

EMQ — Extended Matching Question · Review

Question 282

Delivery suite → Haemorrhage

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Destination Site

Type EEMQ

UUID 7e2bfbeb-43ef-4b2c-919c-5227860eded0

Classification

Speciality

Obstetrics and Gynaecology

Group

Clinical

Title

Delivery suite

Topic

Haemorrhage

Subtopic 1

Antepartum haemorrhage

Subtopic 2

General

Subtopic 3

Active intrapartum bleeding fetal monitoring

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 31-year-old G3P2 at 39+0 weeks enters spontaneous labour following an unexplained APH at 35 weeks. At 5 cm dilatation she develops a further 60 mL fresh vaginal bleed. Her pulse and blood pressure are normal, the uterus is soft between contractions and the fetal heart trace at the time of assessment is reassuring. Labour is progressing normally.

Answer Bank

A Continuous electronic fetal monitoring

B Intermittent auscultation every 30 minutes only

C Maternal fetal-movement perception alone

D No further fetal monitoring because the initial trace is reassuring

E Two-hourly ultrasound instead of fetal heart monitoring

F Fetal blood sampling at fixed hourly intervals

G Doppler velocimetry between every contraction

H Auscultation only if maternal observations deteriorate

Correct Answer

A. Continuous electronic fetal monitoring

Explanation

Active vaginal bleeding during labour represents continuing risk to fetal wellbeing. Continuous electronic fetal monitoring is therefore appropriate even when maternal observations and the initial fetal heart trace are reassuring. A normal assessment at one point does not remove the possibility of subsequent acute fetal compromise while bleeding continues.

Option Validity

B) Intermittent auscultation is insufficient in the presence of active intrapartum bleeding.

C) Maternal perception of fetal movement cannot replace fetal heart rate surveillance during labour.

D) A reassuring initial trace does not eliminate the ongoing risk associated with active bleeding.

E) Intermittent ultrasound is not a substitute for continuous electronic fetal monitoring.

F) Routine fixed-interval fetal blood sampling is not the appropriate surveillance strategy.

G) Doppler velocimetry is not a substitute for continuous intrapartum fetal heart rate monitoring.

H) Fetal surveillance should not wait for maternal deterioration.

Source & metrics

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4.00

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Updated

2026-10-06 01:57:35

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