6.1 C) Viii) Obstetrics And Gynaecology Antepartum Haemorrhage

Front 1

Which is incorrect regarding Placenta previa ?

A. It involves implantation of the placenta over or near the internal os.
B. Its onset is usually < 27 weeks
C. Smoking is a risk factor
D. Pelvic examination is contraindicated in the ED.

Back 1

B. Onset typically between 27-32 weeks

gestation

Front 2

Which is incorrect regarding Placenta previa?
A. It should be suspected with a presentation of bright red, painless,

vaginal bleeding in the second half of pregnancy.

B. Risk factors include increased maternal age and multiparity.
C. Ultrasound is accurate for locating placenta.
D. The maternal mortality is 0.3%

Back 2

D. Maternal mortality = 0.03%

Front 3

Which is incorrect regarding Antepartum

haemorrhage?
A. Painless , bright red bleeding suggests placenta previa.

B. Painful, dark red bleeding suggests placental abruption.
C. Placental abruption is the premature

separation of the placenta from its insertion on the uterine wall.
D. The incidence of abruptio placentae is 0.1%

Back 3

D. Placental abruption incidence = 1%

Front 4

Which is correct regarding

placental abruption ?
A. The commonest cause is Trauma
B. Vaginal bleeding occurs in 95% cases
C. Fetal and maternal death is usually from haemorrhage and

coagulopathy.
D. Fetal distress occurs in 75%

Back 4

C.

A = hypertension (45%) is the commonest cause
B = Vaginal bleeding in 80% cases
D = Fetal distres occurs in 60% cases

Front 5

Which is correct regarding placental abruption?

A. If unstable, Delivery is required.
B. Uterine tenderness and abdominal / back pain occurs in 90% cases.
C. Premature labour occurs in 10%
D. Ultrasound is highly sensitive.

Back 5

A.

B = Abdominal / back pain and uterine

tenderness in 70%
C = Premature labour in 25%
D = USS is insufficiently sensitive to exclude abruption.

Front 6

Which is incorrect regarding Vasa Praevia?
A. It is rare: 1 : 3000 pregnancies.
B. It is due to trapping of placental / cord vessels between the fetus and cervix, which get torn during labour.
C. The CTG is the most prominent diagnostic tool- with fetal decelerations occurring.
D.Maternal shock can be significant.

Back 6

D. There are no Maternal haemodynamic changes.

Front 7

In regards to placenta Praevia, which is correct?
A. Management is usually Emergency Vaginal delivery.

B. Bleeding is never spontaneous- it requires the trauma of labour.
C. There is a 95% fetal mortality rate.
D. Umbilical vessels are typically torn during labour.

Back 7

D.

A = Placenta Praevia =

Emergency Caesarian Section
B = Bleeding can be spontaneous in late

pregnancy
C = 75% fetal mortality

Front 8

( ED MCQ Book 2012 )
In regards to Placental abruption, which of the following is incorrect ?
A. Back pain may be the only presenting symptoms of placental

abruption.

B. There are often features of fetal distress.
C. It is primarily an imaging / laboratory diagnosis.

D. It is often associated with the development of DIC.

Back 8

C. Placental abruption is primarily a

Clinical diagnosis.

USS has limited sensitivity ( NPV 63-88%)

Fibrinogen level < 3 g/L diagnostic of

consumptive coagulopathy.

Front 9

( ED MCQ Book 2012 )
Which of the following is incorrect regarding

Placenta praevia ?
A. The painless, bright "sentinel bleed" can stop spontaneously, but often recurs.
B. Transabdominal USS is poorly sensitive.
C. Vaginal examination should never be performed in suspected placenta praevia.

D. There is typically no fetal distress on CTG.

Back 9

C. Not in the ED.
It can be performed by the Obstetrician rarely in the Theatre when USS is unavailable / cannot

exclude it.

Front 10

List 5 risk Factors associated with

Abruptio Placentae.

Back 10

1. Hypertension (Chronic / pregnancy induced )

2. Trauma

3. Advance Maternal Age

4. Previous Abruptio Placentae

5. Hx Caesarian Section / Uterine Surgery

6. Smoking

7. Cocaine

8. Black race

Front 11

List the complications of Abruptio Placentae.

Back 11

Maternal

1. Haemorrhagic Shock

2. DIC

3. Multi-organ failure

4. Uterine rupture

Neonatal

1. Death

2. Neurodevelopmental abnormalities

Front 12

What % of pregnancies does Abruptio

Placentae occur ?

Back 12

1%

Front 13

List the 3 Subclasses of Placenta Previa.

Back 13

1. Marginal

2. Partial

3. Complete.

Front 14

In regards to Vasa previa, which of the following is incorrect ?

A. The perinatal mortality ranges 30-50%.

B. Placenta previa is a risk factor.

C. It is seldom recognised prior to vessel disruption and fetal

exsanguination.

D. Haemorrhage usually occurs during spontaneous rupture of

membranes.

Back 14

A. 30-100% perinatal mortality.