NCC EFM EXAM QUESTIONS AND VERIFIED ANSWERS
Causes of uteroplacental perfusion decrease:
• HTN
• Pregnancy
• DM
• Hypotension
• Excessive uterine contractions (hypertonus)
• Decreased surface area, edema, degenerative calcifications, infarcts, infection
FHR reflects fetal oxygenation from which extrinsic factors:
• Maternal oxygenation
• Uterine blood flow
• Placental change
• Umbilical blood flow
FHR reflects oxygenation from which intrinsic factors:
• Fetal circulation
• Oxygenation of tissues
• FHR regulation
Fetal shunts:
• Ductus venosus- liver
• PFO- Right to left atria
• Ductus arteriosis- pulmonary a. to aorta
Oxygen depletion cascade:
• Aerobic metabolism
• Hypoxemia
• Tissue hypoxia
• Anaerobic metabolism
• Lactic acid build up
• Metabolic acidosis
Sympathetic innervation:
• Releases Eip/norepi
• Increases FHR
, Parasympathetic/Vagal innervation:
• Releases ach
• Decreases FHR and transmits variability
Early decel:
• Fetal head compression
• ->vasovagal response
Variable decel:
• Cord compression
• ->increase BP/HTN
• ->activation of baroreceptor
• ->decrease FHR, BP, and CO
Late decel:
• Inadequate uteroplacental blood flow->decreased maternal fetal O2 transfer
• ->activation of chemoreceptors to respond due to increased PCO2, decreased PO2,
and decreased pH
• ->Fetal bradycardia and hypertension
Category I:
• Normal fetal acid base status
• All the following are required:
• Moderate variability
• Baseline rate 110-160
• Late or variable decels are absent
• Early decels present or absent
• Accels present or absent
Category II:
• Indeterminate compensatory response
• Not category I or II
Category III:
• Abnormal fetal acid-base status
• Either required
• Absent variability with:
Causes of uteroplacental perfusion decrease:
• HTN
• Pregnancy
• DM
• Hypotension
• Excessive uterine contractions (hypertonus)
• Decreased surface area, edema, degenerative calcifications, infarcts, infection
FHR reflects fetal oxygenation from which extrinsic factors:
• Maternal oxygenation
• Uterine blood flow
• Placental change
• Umbilical blood flow
FHR reflects oxygenation from which intrinsic factors:
• Fetal circulation
• Oxygenation of tissues
• FHR regulation
Fetal shunts:
• Ductus venosus- liver
• PFO- Right to left atria
• Ductus arteriosis- pulmonary a. to aorta
Oxygen depletion cascade:
• Aerobic metabolism
• Hypoxemia
• Tissue hypoxia
• Anaerobic metabolism
• Lactic acid build up
• Metabolic acidosis
Sympathetic innervation:
• Releases Eip/norepi
• Increases FHR
, Parasympathetic/Vagal innervation:
• Releases ach
• Decreases FHR and transmits variability
Early decel:
• Fetal head compression
• ->vasovagal response
Variable decel:
• Cord compression
• ->increase BP/HTN
• ->activation of baroreceptor
• ->decrease FHR, BP, and CO
Late decel:
• Inadequate uteroplacental blood flow->decreased maternal fetal O2 transfer
• ->activation of chemoreceptors to respond due to increased PCO2, decreased PO2,
and decreased pH
• ->Fetal bradycardia and hypertension
Category I:
• Normal fetal acid base status
• All the following are required:
• Moderate variability
• Baseline rate 110-160
• Late or variable decels are absent
• Early decels present or absent
• Accels present or absent
Category II:
• Indeterminate compensatory response
• Not category I or II
Category III:
• Abnormal fetal acid-base status
• Either required
• Absent variability with:
