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Question 99
Delivery suite → Haemorrhage
Classification
Question
SSBAQuestion Header
A woman with a previous placental abruption seeks preconception advice. She smokes 20 cigarettes daily. Which modifiable intervention is specifically relevant to reducing her risk profile for recurrent placental abruption?
Question Stem
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Options
A
Smoking cessation
B
Routine cervical cerclage
C
Prophylactic broad-spectrum antibiotics
D
Avoidance of sexual intercourse throughout pregnancy
E
Routine elective caesarean birth at 34 weeks
Explanation
Maternal smoking is a recognised modifiable risk factor for placental abruption. Smoking cessation should therefore form part of preconception and antenatal counselling, particularly in a woman who already has the important non-modifiable risk factor of previous abruption. Risk-factor modification does not eliminate recurrence risk, so the subsequent pregnancy still requires appropriate antenatal assessment and surveillance.
Option Validity
B) cervical cerclage does not prevent placental abruption.
C) prophylactic antibiotics do not reduce recurrence of placental abruption.
D) routine abstinence from intercourse is not an established preventive intervention for abruption.
E) previous abruption does not automatically mandate elective caesarean birth at 34 weeks.
Further Reading
RCOG Green-top Guideline No. 63. Antepartum Haemorrhage. Royal College of Obstetricians and Gynaecologists; 2011.