Exam Bank for EFM- Questions Fully Solved Latest Version () Already Passed

Exam Bank for EFM- Questions Fully Solved Latest Version () Already Passed A full description of a fetal heart rate tracing requires a qualitative and quantitative description of uterine contractions, as well as: - Answers 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. Baseline fetal heart rate is the approximate mean fetal heart rate rounded to increments of 5 beats per minute (bpm) during a 10-minute segment, excluding: - Answers 1. Accelerations 2. Decelerations 3. Periods of marked variability ( 25 beats per minute) baseline fetal heart rate - Answers is the approximate mean fetal heart rate rounded to increments of 5 beats per minute during a 10-minute segment. Note that the baseline is defined as a single rate not as a range. In any 10-minute window the minimum baseline duration must be at least 2 minutes (not necessarily contiguous) or the baseline for that period is indeterminate. In this case one may need to refer to the previous 10-minute segment(s) for determination of the baseline. fetal bradycardia - Answers is 110 beats per minute fetal tachycardia - Answers is 160 bpm Evaluation of a fetal heart rate pattern must take into account maternal medical conditions as well as estimated gestational age. true or false? - Answers true Baseline variability is defined as fluctuations in the baseline that are regular in amplitude and frequency. true or false? - Answers false Short-term (beat-to-beat) variability is distinct from long-term variability and should be visually determined and documented separately. true or false? - Answers false----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. baseline variability - Answers Baseline variability is defined as fluctuations in the baseline that are irregular in amplitude and frequency. Acceleration is defined as a visually apparent gradual increase in the fetal heart rate above baseline. true or false? - Answers false At 32 weeks of gestation and beyond, a fetal heart rate acceleration is defined by a peak at least 20 beats per minute above the baseline and a duration of at least 20 seconds. true or false? - Answers false. At 32 weeks of gestation and beyond, an acceleration has a peak of 15 beats per minute or more above the baseline, with a duration of 15 seconds or more, but less than 2 minutes from onset to return. Before 32 weeks of gestation, an acceleration is defined as an abrupt increase in the fetal heart rate at least 10 beats per minute above baseline lasting at least 10 seconds. - Answers true Fetal heart rate variability is measurable only with a direct fetal electrode; it cannot be defined using an external Doppler device. true or false? - Answers false acceleration - Answers 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. abrupt - Answers 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.) gradual - Answers Gradual = Onset to peak ≥ 30 seconds Gradual = Onset to nadir ≥ 30 seconds what is abrupt or gradual pertaining to peak? - Answers accelerations what is abrupt or gradual pertaining to nadir? - Answers decelerations nadir - Answers means the lowest point prolonged acceleration - Answers An acceleration that lasts 2 minutes or more, but less than 10 minutes, baseline change - Answers If an acceleration lasts 10 minutes or longer, periodic vs episodic - Answers Periodic patterns are those associated with uterine contractions. Periodic patterns occur with periodicity, as do uterine contractions. On the other hand, episodic decelerations are those NOT associated with uterine contractions. Late decelerations - Answers A deceleration that begins after the onset of a uterine contraction, reaches its nadir (lowest point) after the peak of the contraction and takes at least 30 seconds to reach its lowest point. The deceleration is delayed in timing, with the nadir of the deceleration occurring after the peak of the contraction. In most cases the onset, nadir, and recovery of a late deceleration occur before the beginning, peak, and ending of the contraction, respectively. true or false?? - Answers false Early decelerations - Answers A gradual deceleration that occurs in association with a uterine contraction and reaches its nadir (lowest point) at the same time as the peak of the contraction Prolonged deceleration - Answers a visually apparent decrease in the fetal heart rate below the baseline. The decrease from the baseline is ≥ 15 beats per minute, lasting ≥ 2 minutes, but 10 minutes from onset to return to baseline. If the deceleration lasts 10 minutes or longer it is called a baseline change. Variable deceleration - Answers a visually apparent abrupt decrease in the fetal heart rate. Variable decelerations are categorized as "mild", "moderate" or "severe" based on depth and duration. - Answers false According to the 2008 NICHD Consensus Report, a 15 beat per minute decrease in the fetal heart rate that lasts for more than 10 minutes is defined as: - Answers change in baseline recurrent decelerations - Answers Fetal heart rate decelerations occurring with ≥ 50% of uterine contractions in any 20-minute window. less than 50 is intermittent sinusoidal pattern lasting for 20 minutes or greater is what category tracing? - Answers category 3 recurrent variables lasting for 20 minutes or greater is what category tracing? - Answers category 2 Category I fetal heart tracings include all of the following: - Answers Baseline rate: 110 - 160 bpm Baseline fetal heart rate variability: moderate Accelerations: present or absent Late or variable decelerations: absent Early decelerations: present or absent A sinusoidal fetal heart rate pattern - Answers 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. Category III fetal heart rate tracings include at least one of the following: - Answers Absent baseline fetal heart rate variability and recurrent late decelerations Absent baseline fetal heart rate variability with recurrent variable decelerations Absent variability with bradycardia for at least 10 minutes Sinusoidal pattern for at least 20 minutes baseline FHR - Answers Baseline fetal heart rate is the approximate mean fetal heart rate rounded to increments of 5 beats/minute during a 10 minute segment. variability - Answers defined as fluctuations in the baseline that are irregular in amplitude and frequency. Amplitude is measured from peak-to-trough in beats per minute. According to the 2014 ACOG-AAP consensus report, Neonatal Encephalopathy and Neurologic Outcome, fetal heart rate accelerations and/or moderate variability reliably predict the absen