Persistent intermenstrual bleeding — DRCOG MCQ

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EasyGynaecologyPersistent intermenstrual bleedingDRCOG

A 34-year-old woman has bleeding between periods for 4 months and a normal pregnancy test. When should this patient be referred?

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Correct answer: D — Refer for gynaecology assessment

Refer for gynaecology assessment is the best answer because the vignette is testing Persistent intermenstrual bleeding and the recommended approach is consistent with NICE NG12. The other referral timings are either too slow for the risk described or use a pathway intended for a different presentation. Specifically, Refer same day to the maternity assessment unit; Refer early for specialist fertility assessment; Refer to sexual assault referral services; Refer immediately to emergency obstetric care would be suboptimal in this scenario. Referral timing is determined by red flags, pregnancy stage and suspected cancer or emergency pathways.

Reference: NICE NG12