CEFM - NCC Exam with Questions and Correct Answers 2025.

CEFM - NCC Exam with Questions and
Correct Answers 2025



What ,are ,some ,important ,factors ,(risks) ,to ,consider ,when ,evaluating ,a ,fetal
,heart ,rate ,strip? ,- ,CORRECT ,ANSWER---*PNLs* ,(abnormal?)
--weight ,gain/loss
--Maternal ,age
--*Gestational ,age*
--*MATERNAL ,vital ,signs*
--*Membrane ,status*
--*Cervical ,exam*

What ,are ,the ,easiest ,ways ,for ,assessment ,of ,maternal ,oxygenation ,status? ,-
,CORRECT ,ANSWER-*Pulse ,Ox* ,(& ,other ,vital ,signs, ,RR)
*Blood ,gas* ,(if ,indicated, ,asthma ,exacerbation)
*Lung ,sounds* ,(pneumonia, ,pulmonary ,edema?)

What ,effect ,can ,*HTN/Preeclampsia* ,have ,on ,the ,Placenta? ,- ,CORRECT
,ANSWER-*VASOCONSTRICTION*
which ,adversely ,affects ,placental ,perfusion ,and ,can ,lead ,to:
--*IUGR*
--*Infarcts* ,(decreases ,functional ,area ,of ,the ,placenta ,& ,functional ,capacity)

Placental ,Infarcts ,- ,CORRECT ,ANSWER-- ,Necrosis ,of ,placental ,villi
- ,Anechoic ,or ,Hypoechoic ,areas ,in ,placenta

Placental ,infarcts ,will ,do ,what ,to ,the ,placental ,function? ,- ,CORRECT ,ANSWER-
*DECREASE ,functional ,area* ,of ,placenta
*DECREASE ,functional ,capacity*

What ,effect ,can ,*Diabetes* ,have ,on ,Placental ,perfusion? ,- ,CORRECT ,ANSWER-
Secondary ,to ,*Maternal ,Vasculopathy* ,& ,HYPERglycemia* ,this ,can ,lead ,to:
*reduced ,utero-placental ,perfusion* ,= ,*IUGR*

What ,can ,change ,for ,fetal ,energy ,demands ,when ,you ,have ,a ,"DIABETIC
,mother" ,uncontrolled ,and ,there ,is ,*Fetal ,HYPERglycemia ,&
,HYPERinsulinemia*? ,- ,CORRECT ,ANSWER-Fetal ,hyperglycemia ,&
,hyperinsulinemia ,can ,cause:
*Increased ,fetal ,O2 ,consumption* ,which ,may ,induce ,*fetal ,hypoxemia ,&
,acidosis* ,if ,the ,O2 ,needs ,of ,the ,fetus ,are ,not ,met ,by ,the ,placenta.

,What ,are ,some ,common ,conditions ,which ,could ,lead ,to ,a ,*POOR ,maternal
,Oxygenation ,status*? ,- ,CORRECT ,ANSWER-Respiratory ,DEPRESSION ,(*Meds
,or ,Seizure*)
*Pulmonary ,EMBOLISM*
*Pneumonia*
*Asthma*
*Atelectasis*
ARDS
*Smoking*
*ANEMIA*

What ,are ,some ,examples ,of ,*collagen-vascular ,diseases*? ,HOw ,does ,these
,effect ,pregnancy? ,- ,CORRECT ,ANSWER-*Rheumatoid ,arthritis*
*Scleroderma*
*SLE* ,(lupus)

= ,maternal ,*vasocontriction* ,which ,can ,lead ,to ,interruptions ,in ,placental ,&
,uterine ,blood ,flow
--'IUGR'

What ,fetal ,cardiac ,condition ,may ,you ,see ,in ,a ,mother ,with ,*SLE* ,(systemic
,lupus ,erythematosis)? ,- ,CORRECT ,ANSWER-*Secondary ,Heart ,BLOCK*


*Renal ,disease* ,(CKD, ,etc.) ,could ,cause ,what? ,- ,CORRECT ,ANSWER-*Maternal
,VASOCONSTRICTION*


= ,maternal ,*vasocontriction* ,which ,can ,lead ,to ,interruptions ,in ,placental ,&
,uterine ,blood ,flow
--'IUGR'

*Thyroid ,Disease* ,could ,cause ,what? ,- ,CORRECT ,ANSWER-*Maternal
,VASOCONSTRICTION*


= ,maternal ,*vasocontriction* ,which ,can ,lead ,to ,interruptions ,in ,placental ,&
,uterine ,blood ,flow
--'IUGR'

What ,is ,the ,concern ,with ,*cardiac ,disease* ,in ,expectant ,mothers? ,- ,CORRECT
,ANSWER-Cardiac ,disease ,----> ,impaired ,cardiac ,function ,or ,even ,cardiac ,failure
,
---> ,*Decrease ,cardiac ,output* ,----> ,decreased ,blood ,flow/oxygen ,flow ,through
,placenta
IUGR, ,etc.

What ,are ,some ,common ,causes ,of ,*Maternal ,HYPOTENSION*? ,- ,CORRECT
,ANSWER-*Supine ,hypotension* ,of ,pregnancy

,*VASODILATION* ,2/2 ,epidural

This ,will ,*DECREASE ,O2 ,& ,blood ,flow ,through ,the ,placenta*.

What ,are ,the ,*Maternal* ,'EXTRINSIC ,factors' ,which ,effect ,delivery ,of ,bloos ,&
,availability ,of ,blood/O2 ,through ,placenta? ,- ,CORRECT ,ANSWER-1. ,*Maternal
,Oxygen ,status*
--fetus ,relies ,on ,the ,ability ,of ,mother ,to ,be ,well-oxygenated
Anything ,that ,interferes ,with ,maternal ,oxygenation ,has ,the ,potential ,to
,compromise ,the ,fetus. ,


2. ,*Maternal ,HEMOGLOBIN ,levels* ,O2 ,is ,released ,from ,the ,maternal ,Hgb ,&
,attaches ,to ,fetal ,Hgb ,(*O2 ,carrying ,capacity*)


3. ,*Cardiac ,OUTPUT* ,-- ,decreased ,CO ,affects ,blood ,flow ,to ,the ,uterus ,&
,placenta.


In ,terms ,of ,Maternal ,Oxygen ,Status, ,in ,order ,for ,there ,to ,be ,*adequate ,arterial
,oxygen ,tension ,(PaO2)* ,-- ,there ,needs ,to ,be ,what? ,- ,CORRECT ,ANSWER-PaO2
,= ,immediately ,available ,O2 ,for ,exchange


Needs ,adequate ,*maternal ,ventilation ,& ,pulmonary ,function*

What ,are ,the ,*'Placental ,factors'* ,which ,can ,effect ,the ,efficiency ,of
,*Uteroplacental ,perfusion*? ,- ,CORRECT ,ANSWER-1. ,'*UTERINE ,Blood ,flow*
2. ,Damaged ,chorionic ,vessels* ,(leaking ,into ,the ,intervillouos ,space)
3. ,*Decrease ,in ,SIZE ,or ,functioning ,area* ,of ,the ,*Placenta*
4. ,*Placental ,Reserve*

There ,can ,be ,Acute ,vs. ,Chronic ,decreases ,in ,uteroplacental ,function.

Describe ,*Uterine ,BLOOD ,flow* ,changes ,during ,pregnancy. ,
--rate, ,% ,of ,CO, , % ,to ,placenta ,vs. ,uterus ,- ,CORRECT ,ANSWER-UTERINE
,BLOOD ,FLOW:


-Nonpregnancy ,rate ,is ,usually ,50ml/min, ,during ,*pregnancy ,= ,700ml/min*!!
-*10-15%* ,of ,total ,*cardiac ,output*

*70-90%* ,of ,this ,blood ,flow ,goes ,to ,*PLACENTA/intervillous ,space* ,=
,intervillous ,space ,perfusion ,is ,dependent ,on ,adequate ,uterine ,blood ,flow.


Compare ,Acute ,vs. ,Chronic ,changes ,in ,uteroplacental ,perfusion/function. ,-
,CORRECT ,ANSWER-*ACUTE*:
sudden ,drop ,in ,placental ,function ,limits ,O2 ,& ,CO2 ,exchange ,which ,can ,lead ,to ,
*fetal ,asphyxia*

, *CHRONIC*:
if ,there ,is ,a ,chronic ,decrease ,in ,placental ,function ,this ,may ,be ,more ,likely ,to
,limit ,*carbohydrate ,transfer* ,& ,can ,lead ,to ,fetal ,growth ,restriction.


Due ,to ,high ,rate ,of ,uterin ,blood ,flow ,in ,pregnancy ,- ,what ,level ,of ,decrease ,can
,be ,tolerated ,prior ,to ,severe ,effects ,on ,fetal ,status? ,- ,CORRECT ,ANSWER-
Uterine ,blood ,flow ,can ,*decrease ,by ,50%* ,befoer ,SEVERE ,acidosis ,develops.

What ,are ,some ,common ,causes ,of ,*damage ,to ,the ,chorionic ,vessels* ,which
,causes ,leakage ,of ,blood ,into ,the ,intervillous ,space ,(fetal-maternal
,hemorrhage)? ,- ,CORRECT ,ANSWER-Damaged ,chorionic ,vessels:
*abdominal ,trauma*
*'spontaneous' ,placental ,abruption* ,(or ,secondary ,to ,cocaine, ,HTN ,disorders,
,etc)
*Invasive ,procedures* ,(amniocentesis, ,CVS)
*Ruptured ,vasa ,previa*

What ,are ,four ,main ,ways ,that ,the ,*size ,or ,functional ,area* ,of ,the ,*placenta* ,can
,be ,compromised? ,- ,CORRECT ,ANSWER-1. ,*ABRUPTION*: ,decreases ,the
,functional ,AREA ,of ,placenta ,(spontaneous, ,trauma, ,procedures)


2. ,*MATERNAL ,DISEASE* ,(HTN)
-disease ,processes ,can ,cause ,smaller ,placenta
-smaller ,placenta ,decreases ,gas ,exchange ,results ,in ,FGR, ,asphyxia ,&
,malnourishment. ,


3. ,*INFECTION*

4. ,*CONGENITAL ,DEFECTS*

What ,is ,the ,*placental ,reserve*? ,- ,CORRECT ,ANSWER-*OXYGEN ,in ,the ,placenta
,DURING ,a ,CONTRACTION* ,when ,there ,is ,*NO ,other ,blood ,flow ,entering ,the
,placenta*


This ,is ,the ,O2 ,reserve ,that ,continues ,oxygenating ,the ,fetus ,until ,the
,contraction ,ends!!!


----Anything ,that ,reduced ,the ,size ,of ,the ,placent ,or ,the ,functioning ,of ,the
,placenta ,decreases ,the ,reserve ,available ,to ,the ,fetus.


What ,are ,common ,risk ,factors ,for ,decreased ,placental ,perfusion/function? ,-
,CORRECT ,ANSWER->> ,*EXCESSIVE ,UTERINE ,ACTIVITY*: ,
*Tachysystole, ,hypertonus* ,or ,leading ,to ,Placental ,abruption. ,

>> ,ABRUPTION