1|Page
AWHONN Advanced Fetal Monitoring 2026/2027 Exam
||Verified Exam|| Sure Pass!!!
Identify the uterine contraction variation: - ANSWER-a. Uterine
contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine
contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
,2|Page
h. Inverted waveform related to placement of toco
What are the advantages and limitation of Toco? - ANSWER-
Advantages- it is external so it is non invasive and ROM is not
necessary
Limitations- it is location sensitive so improper placement or
movement can cause uninterpretable tracing. It is not a means
of assessing true resting tone or intensity so must use in
conjunction with direct palpation. Toco only gives an
approximate measure of duration and frequency. Reading can
vary greatly based on mat. weight, mat. position, and position
of belt.
Select the best location for placement of Toco for a term
pregnancy. - ANSWER-top center is where you should receive
the most accurate reading of uterine contractions as term.
What is an Intrauterine pressure catheter (IUPC) and what does
it measure? - ANSWER-It is the only method that directly
measures the uterine resting tone, contraction intensity,
frequency and duration. It is an invasive procedure that requires
ROM and cervical dilation. IUPC is used when there is a need for
more detailed information than palpation or toco can provide.
,3|Page
The IUPC measures hydrostatic pressure in the uterus,
measuring intrauterine pressure during and between
contractions.
What are indications for IUPC monitoring? - ANSWER-1. When
labor and not progressing & assessment of the adequacy of the
contraction is needed.
2. When the nature or event of previous uterine scarring
necessitates internal monitoring
3. Amnioinfusion is required
4. Differentiation of FHR patterns relative to contractions is
needed
How are IUPC tracings displayed, what are normal values? -
ANSWER-Similar to toco tracings, contractions are in (mm HG)
and appear as elevations from the baseline resting tone and are
quantified measures of contractions intensity and resting tone.
Normal baseline tone is 5-20 mmHg
Mild contractions w/ peak of <40 mm Hg
Moderate contractions w/ peak of 40-70 mm Hg
Strong contractions w/ peak of >70 mm Hg
, 4|Page
Does this IUPC tracing show normal resting tone or elevated
tone? - ANSWER-Normal resting tone
15 mm Hg is with in normal range of 5-20 mm Hg
Does this IUPC tracing show normal resting tone or elevated
tone ? - ANSWER-Elevated tone
30 mmHg is above the normal resting tone of 20-25
Does this IUPC tracing show normal resting tone or elevated
tone ? - ANSWER-Normal resting tone
15 mm Hg is with in the normal range of 5-20 mm Hg
How is an IUPC intrauterine pressure catheter placed? -
ANSWER-Used to measure uterine contractions it is inserted via
sterile introducer tube placed within the cervix next to the
presenting part. The catheter itself is flexible is inserted into the
uterus. Insertion is complete when the mark on the catheter is
just visible at the introitus.
Discuss troubleshooting of the IUPC - ANSWER-*check all
attachment points
AWHONN Advanced Fetal Monitoring 2026/2027 Exam
||Verified Exam|| Sure Pass!!!
Identify the uterine contraction variation: - ANSWER-a. Uterine
contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine
contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
,2|Page
h. Inverted waveform related to placement of toco
What are the advantages and limitation of Toco? - ANSWER-
Advantages- it is external so it is non invasive and ROM is not
necessary
Limitations- it is location sensitive so improper placement or
movement can cause uninterpretable tracing. It is not a means
of assessing true resting tone or intensity so must use in
conjunction with direct palpation. Toco only gives an
approximate measure of duration and frequency. Reading can
vary greatly based on mat. weight, mat. position, and position
of belt.
Select the best location for placement of Toco for a term
pregnancy. - ANSWER-top center is where you should receive
the most accurate reading of uterine contractions as term.
What is an Intrauterine pressure catheter (IUPC) and what does
it measure? - ANSWER-It is the only method that directly
measures the uterine resting tone, contraction intensity,
frequency and duration. It is an invasive procedure that requires
ROM and cervical dilation. IUPC is used when there is a need for
more detailed information than palpation or toco can provide.
,3|Page
The IUPC measures hydrostatic pressure in the uterus,
measuring intrauterine pressure during and between
contractions.
What are indications for IUPC monitoring? - ANSWER-1. When
labor and not progressing & assessment of the adequacy of the
contraction is needed.
2. When the nature or event of previous uterine scarring
necessitates internal monitoring
3. Amnioinfusion is required
4. Differentiation of FHR patterns relative to contractions is
needed
How are IUPC tracings displayed, what are normal values? -
ANSWER-Similar to toco tracings, contractions are in (mm HG)
and appear as elevations from the baseline resting tone and are
quantified measures of contractions intensity and resting tone.
Normal baseline tone is 5-20 mmHg
Mild contractions w/ peak of <40 mm Hg
Moderate contractions w/ peak of 40-70 mm Hg
Strong contractions w/ peak of >70 mm Hg
, 4|Page
Does this IUPC tracing show normal resting tone or elevated
tone? - ANSWER-Normal resting tone
15 mm Hg is with in normal range of 5-20 mm Hg
Does this IUPC tracing show normal resting tone or elevated
tone ? - ANSWER-Elevated tone
30 mmHg is above the normal resting tone of 20-25
Does this IUPC tracing show normal resting tone or elevated
tone ? - ANSWER-Normal resting tone
15 mm Hg is with in the normal range of 5-20 mm Hg
How is an IUPC intrauterine pressure catheter placed? -
ANSWER-Used to measure uterine contractions it is inserted via
sterile introducer tube placed within the cervix next to the
presenting part. The catheter itself is flexible is inserted into the
uterus. Insertion is complete when the mark on the catheter is
just visible at the introitus.
Discuss troubleshooting of the IUPC - ANSWER-*check all
attachment points
