EMQ

EMQ — Extended Matching Question · Review

Question 290

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

Maternal observations severity integration

Question Type

EMQ

Question

EEMQ

Question Header

Question Stem

A 30-year-old primigravida at 33+1 weeks presents with APH. Approximately 350 mL of blood is visible. On arrival she is alert, pulse 96/min and blood pressure 116/72 mmHg. Twenty minutes later the visible bleeding has almost stopped, but she becomes restless and pale, pulse rises to 124/min and blood pressure falls to 94/58 mmHg. The abdomen is increasingly tender. A repeat pad contains little additional blood.

Answer Bank

A The haemorrhage is improving because the pad contains little new blood

B Severity remains fixed by the original 350 mL estimate

C Maternal deterioration is relevant only if haemoglobin falls below 80 g/L

D Stable fetal assessment would exclude clinically important maternal haemorrhage

E The episode should remain classified as minor because bleeding has slowed

F Repeat maternal observations are unnecessary once the initial assessment is recorded

G Serial maternal physiological assessment is essential because clinical deterioration may reveal ongoing or concealed haemorrhage despite little further visible loss

H Ultrasound-estimated blood volume should replace maternal observations

Correct Answer

G. Serial maternal physiological assessment is essential because clinical deterioration may reveal ongoing or concealed haemorrhage despite little further visible loss

Explanation

APH is dynamic. Severity cannot be frozen at the initial visual estimate. Progressive tachycardia, falling blood pressure, pallor and restlessness indicate worsening maternal compromise and raise concern about ongoing or concealed haemorrhage even when little additional external blood is seen. Serial maternal assessment is therefore central to recognising deterioration.

Option Validity

A) Reduced visible bleeding does not establish haemorrhage control when maternal physiology is worsening.

B) Severity must be reassessed dynamically rather than fixed by the first volume estimate.

C) Clinical deterioration should not await a specific haemoglobin threshold.

D) Maternal haemorrhage can progress even if fetal assessment is temporarily reassuring.

E) Physiological compromise is inconsistent with classifying the episode merely from a small external volume.

F) Repeated observations are essential in an evolving haemorrhagic presentation.

H) Imaging cannot replace serial maternal physiological assessment.

Source & metrics

Authored Difficulty

4.00

Evaluation Score

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Destination

eBook

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Updated

2026-10-06 01:57:35

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