EFM Questions and Answers
A full description of a fetal heart rate tracing requires a qualitative and quantitative description of
uterine contractions, as well as: - ✔✔1. Baseline rate
2. Baseline fetal heart rate variability
3. Presence of accelerations
4. Periodic or episodic decelerations
5. Changes or trends of fetal heart rate patterns over time
No distinction is made between short-term variability (or beat-to-beat variability or R-R wave period
differences in the electrocardiogram) and long-term variability because in actual practice they are
visually determined as a unit.
a mature fetus would be expected to have L/S (lecithin to Sphingomyelin) ratio on _____ and the ____
of PG (phosphatidylglycerol - ✔✔2.0, presence
a non reactive tracing is an absence of what in a 40 minute window? - ✔✔2 accelerations
A sinusoidal fetal heart rate pattern - ✔✔is a visually apparent, smooth, sine wave-like undulating
pattern in the fetal heart rate baseline with a cycle frequency of 3-5 per minute which persists for 20
minutes or more.
a sinusoidal pattern may be described in association with ________ - ✔✔severe fetal anemia, chore,
fetal sepsis, narcotic administration
ABCD - ✔✔A)assess oxygenation pathway
B) begin corrective measures
, (reassessment FHR category between AB to CD-- look for significant decelerations or presence of
moderate variability/accels then decide next step of action),
C) Clear obstacles for/to rapid delivery
D) Decision to delivery time
E) expedite delivery2 main principles of FHR interpretation - ✔✔Principle # 1: Variable, late or prolonged
decelerations signal interruption of the oxygen pathway at one or more points.
Principle # 2: Moderate variability and/or accelerations reliably predict the absence of on-going fetal
hypoxic neurologic injury at the time they are observed.
28 weeker w/ O- blood was in a MVA. She needs what important test? - ✔✔kleihauer-betke
37 weeks pt with itching on palms and feet and nausea/vomiting. You can anticipate what syndromes -
✔✔cholestatsis (gallbladder=n/v) and early delivery
a _______ OCT requires the patient to have 3 contractions in 10 minutes with no late decelerations -
✔✔negative
a base deficit of greater than or equal to ____ is sufficient enough to cause cerebral palsy - ✔✔12
A Catetory II tracing _____________. - ✔✔
abrupt - ✔✔Abrupt = Onset to peak < 30 seconds
Abrupt = Onset to nadir < 30 seconds ( The decrease is ≥ 15 beats per minute, lasting ≥ 15 seconds, and
< 2 minutes from onset to return to baseline.)
abruption can lead to DIC because of too much what in the blood? - ✔✔thromboplastin
acceleration - ✔✔is defined as a visually apparent abrupt increase (defined as onset of acceleration to
peak in < 30 seconds) in the fetal heart rate above the baseline.
A full description of a fetal heart rate tracing requires a qualitative and quantitative description of
uterine contractions, as well as: - ✔✔1. Baseline rate
2. Baseline fetal heart rate variability
3. Presence of accelerations
4. Periodic or episodic decelerations
5. Changes or trends of fetal heart rate patterns over time
No distinction is made between short-term variability (or beat-to-beat variability or R-R wave period
differences in the electrocardiogram) and long-term variability because in actual practice they are
visually determined as a unit.
a mature fetus would be expected to have L/S (lecithin to Sphingomyelin) ratio on _____ and the ____
of PG (phosphatidylglycerol - ✔✔2.0, presence
a non reactive tracing is an absence of what in a 40 minute window? - ✔✔2 accelerations
A sinusoidal fetal heart rate pattern - ✔✔is a visually apparent, smooth, sine wave-like undulating
pattern in the fetal heart rate baseline with a cycle frequency of 3-5 per minute which persists for 20
minutes or more.
a sinusoidal pattern may be described in association with ________ - ✔✔severe fetal anemia, chore,
fetal sepsis, narcotic administration
ABCD - ✔✔A)assess oxygenation pathway
B) begin corrective measures
, (reassessment FHR category between AB to CD-- look for significant decelerations or presence of
moderate variability/accels then decide next step of action),
C) Clear obstacles for/to rapid delivery
D) Decision to delivery time
E) expedite delivery2 main principles of FHR interpretation - ✔✔Principle # 1: Variable, late or prolonged
decelerations signal interruption of the oxygen pathway at one or more points.
Principle # 2: Moderate variability and/or accelerations reliably predict the absence of on-going fetal
hypoxic neurologic injury at the time they are observed.
28 weeker w/ O- blood was in a MVA. She needs what important test? - ✔✔kleihauer-betke
37 weeks pt with itching on palms and feet and nausea/vomiting. You can anticipate what syndromes -
✔✔cholestatsis (gallbladder=n/v) and early delivery
a _______ OCT requires the patient to have 3 contractions in 10 minutes with no late decelerations -
✔✔negative
a base deficit of greater than or equal to ____ is sufficient enough to cause cerebral palsy - ✔✔12
A Catetory II tracing _____________. - ✔✔
abrupt - ✔✔Abrupt = Onset to peak < 30 seconds
Abrupt = Onset to nadir < 30 seconds ( The decrease is ≥ 15 beats per minute, lasting ≥ 15 seconds, and
< 2 minutes from onset to return to baseline.)
abruption can lead to DIC because of too much what in the blood? - ✔✔thromboplastin
acceleration - ✔✔is defined as a visually apparent abrupt increase (defined as onset of acceleration to
peak in < 30 seconds) in the fetal heart rate above the baseline.
