INTERMEDIATE FETAL MONITORING TEST
COMPLETE STUDY GUIDE WITH SOLVED
QUESTIONS
◉ Transient FHR change.
Answer: A change that does not meet the 10-minute requirement for
a baseline change.
◉ FHR variability.
Answer: Fluctuations in the FHR around the baseline that reflect
interaction between the sympathetic and parasympathetic nervous
systems.
◉ Absent variability.
Answer: Amplitude range is undetectable.
◉ Minimal variability.
Answer: Amplitude range is detectable but 5 bpm or less.
◉ Moderate variability.
Answer: Amplitude range is 6-25 bpm.
,◉ Marked variability.
Answer: Amplitude range is greater than 25 bpm.
◉ Most reassuring variability pattern.
Answer: Moderate variability.
◉ Why moderate variability matters.
Answer: It indicates an intact fetal autonomic nervous system and is
associated with adequate fetal oxygenation at that point in time.
◉ Causes of minimal variability.
Answer: Fetal sleep, prematurity, medications, fetal
hypoxemia/acidemia, CNS abnormalities, and other physiologic
conditions.
◉ Fetal sleep cycle.
Answer: Can temporarily decrease FHR variability and reduce
accelerations.
◉ Medication-associated decreased variability.
Answer: Opioids, magnesium sulfate, sedatives, and anesthetic
medications may decrease variability.
, ◉ Absent variability alone.
Answer: Does not automatically mean Category III; the associated
FHR pattern determines the category.
◉ Acceleration.
Answer: Abrupt increase in FHR above the baseline.
◉ Acceleration ≥32 weeks.
Answer: Increase of at least 15 bpm lasting at least 15 seconds and
less than 2 minutes.
◉ Acceleration <32 weeks.
Answer: Increase of at least 10 bpm lasting at least 10 seconds and
less than 2 minutes.
◉ Prolonged acceleration.
Answer: Acceleration lasting 2 minutes or longer but less than 10
minutes.
◉ Acceleration lasting ≥10 minutes.
Answer: Considered a baseline change rather than an acceleration.
◉ Clinical significance of accelerations.
COMPLETE STUDY GUIDE WITH SOLVED
QUESTIONS
◉ Transient FHR change.
Answer: A change that does not meet the 10-minute requirement for
a baseline change.
◉ FHR variability.
Answer: Fluctuations in the FHR around the baseline that reflect
interaction between the sympathetic and parasympathetic nervous
systems.
◉ Absent variability.
Answer: Amplitude range is undetectable.
◉ Minimal variability.
Answer: Amplitude range is detectable but 5 bpm or less.
◉ Moderate variability.
Answer: Amplitude range is 6-25 bpm.
,◉ Marked variability.
Answer: Amplitude range is greater than 25 bpm.
◉ Most reassuring variability pattern.
Answer: Moderate variability.
◉ Why moderate variability matters.
Answer: It indicates an intact fetal autonomic nervous system and is
associated with adequate fetal oxygenation at that point in time.
◉ Causes of minimal variability.
Answer: Fetal sleep, prematurity, medications, fetal
hypoxemia/acidemia, CNS abnormalities, and other physiologic
conditions.
◉ Fetal sleep cycle.
Answer: Can temporarily decrease FHR variability and reduce
accelerations.
◉ Medication-associated decreased variability.
Answer: Opioids, magnesium sulfate, sedatives, and anesthetic
medications may decrease variability.
, ◉ Absent variability alone.
Answer: Does not automatically mean Category III; the associated
FHR pattern determines the category.
◉ Acceleration.
Answer: Abrupt increase in FHR above the baseline.
◉ Acceleration ≥32 weeks.
Answer: Increase of at least 15 bpm lasting at least 15 seconds and
less than 2 minutes.
◉ Acceleration <32 weeks.
Answer: Increase of at least 10 bpm lasting at least 10 seconds and
less than 2 minutes.
◉ Prolonged acceleration.
Answer: Acceleration lasting 2 minutes or longer but less than 10
minutes.
◉ Acceleration lasting ≥10 minutes.
Answer: Considered a baseline change rather than an acceleration.
◉ Clinical significance of accelerations.
