1|Page
AWHONN Advanced Fetal Monitoring Exam|| Complete
Exam with Questions and Correct Answers!!!|| LatesT
Exam!!!
What does the Tocodynamometer measure? - ANSWER-
Contractions by detecting abdominal wall contour
changes. The device converts this to electronic impulses
that register and print out on paper.
Toco does NOT quantify resting tone or intensity of
contractions. Changes of the abd wall can be caused by a
number of events besides contractions (mat. respirations,
pushing, vomiting, seizures, fetal activity and movement).
A normal contraction creates a smooth and even fall on
the tracing
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
,2|Page
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.
The IUPC measures hydrostatic pressure in the uterus,
measuring intrauterine pressure during and between
contractions.
,3|Page
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
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
, 4|Page
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
*verify position (can be displaced or perforated uterus or
uterine rupture) have pt cough/valsalva if place correctly
tracing will spike with cough simultaneously
palpate abd to verify presence/absence of contractions
*a tracing with no visible resting tone may be improperly
zeroed.
AWHONN Advanced Fetal Monitoring Exam|| Complete
Exam with Questions and Correct Answers!!!|| LatesT
Exam!!!
What does the Tocodynamometer measure? - ANSWER-
Contractions by detecting abdominal wall contour
changes. The device converts this to electronic impulses
that register and print out on paper.
Toco does NOT quantify resting tone or intensity of
contractions. Changes of the abd wall can be caused by a
number of events besides contractions (mat. respirations,
pushing, vomiting, seizures, fetal activity and movement).
A normal contraction creates a smooth and even fall on
the tracing
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
,2|Page
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.
The IUPC measures hydrostatic pressure in the uterus,
measuring intrauterine pressure during and between
contractions.
,3|Page
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
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
, 4|Page
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
*verify position (can be displaced or perforated uterus or
uterine rupture) have pt cough/valsalva if place correctly
tracing will spike with cough simultaneously
palpate abd to verify presence/absence of contractions
*a tracing with no visible resting tone may be improperly
zeroed.
