ADVANCED FETAL MONITORING FINAL EXAM
2025/2026 QUESTIONS AND ANSWERS GRADED
A+
Why does the supine position cause decreased uteroplactenal blood flow?
The aorta and vena cava get compressed (20 weeks)
Why does maternal hypotension happen after regional analgesia?
Blocks the sympathetic pathway
Pooling of blood in the lower extremities decreases blood flow back to moms heart
which decreases blood flow to the fetus
What percentage is uteroplacental blood flow decreased by during cxts?
60%
Explain the pathway for maternal- fetal exchange for fetal oxygenation (basic)
Environment to lungs to heart to vasculature to uterus to placenta to umbilical cord
Where is the least O2 blood in the fetus?
Limbs, kidneys, and descending aorta
,Where is the most O2 blood in the fetus?
Umbilical vein and ductous venous
What category rules out fetal acidemia?
Cat 1
What maternal conditions greatly impact fetal oxygenation?
Severe astha, cardiac issues, and ecclampic seizures
Where does the exchange of O2 and nutrients take place?
intervillous space
How is o2 blood transferred to the fetus?
O2 enters the intervillous space via the maternal arteries, to the villi then the
umbilical vein take the o2 blood to the fetus. The umbilical arteries take the deO2
blood from the baby through the villi and back to the mother
Diffusion
High to low concentration
Mom to fetus for O2
Low to high concentration for CO2 so baby to mom
,How is O2 transferred from mom to baby
Diffusion
What will ST-segment analysis tell you?
- Theoretically, ST-segment analysis of the fetal ECG provides continuous
information regarding the ability of the fetal heart to respond to stress in labor by
providing information about intracardiac responses to intrapartum hypoxia.
- Analysis of the ST segment may permit detection of myocardial ischemia and the
fetus' ability to respond to stress prior to peripheral organ and central nervous
system damage.
When do ST-segment and T-wave changes occur?
with myocardial ischemia, prior to permanent cell damage.
What are ST-segment and T-wave elevation indicative of?
fetus at risk of developing hypoxia but still capable of responding against
hypoxemia.
What are ST-segment and T-wave depression indicative of?
has been associated with the inability of the fetal heart to further respond to
hypoxia, indicating that the fetus either had no time to respond or has exhausted
compensatory mechanisms.
, When are fetal ST changes clinically relevant?
when they coincide with category 2 tracings
How do you differentiate an irregular heart rate from possible artifact or electronic
interference?
- auscultation
- ultrasound
- echocardiogram
- ecg
What is an arrhythmia?
- the sporadic, irregular beats typical of the frequent fetal events heard or recorded
on the tracing
- When there is a disturbance in the heart cell's ability to form and discharge an
impulse independently (automaticity & excitability), cardiac rhythm may become
tachycardic, bradycardic, or irregular with ectopic beats or premature rhythms such
as premature atrial contractions.
How are arrythmias categorized?
2025/2026 QUESTIONS AND ANSWERS GRADED
A+
Why does the supine position cause decreased uteroplactenal blood flow?
The aorta and vena cava get compressed (20 weeks)
Why does maternal hypotension happen after regional analgesia?
Blocks the sympathetic pathway
Pooling of blood in the lower extremities decreases blood flow back to moms heart
which decreases blood flow to the fetus
What percentage is uteroplacental blood flow decreased by during cxts?
60%
Explain the pathway for maternal- fetal exchange for fetal oxygenation (basic)
Environment to lungs to heart to vasculature to uterus to placenta to umbilical cord
Where is the least O2 blood in the fetus?
Limbs, kidneys, and descending aorta
,Where is the most O2 blood in the fetus?
Umbilical vein and ductous venous
What category rules out fetal acidemia?
Cat 1
What maternal conditions greatly impact fetal oxygenation?
Severe astha, cardiac issues, and ecclampic seizures
Where does the exchange of O2 and nutrients take place?
intervillous space
How is o2 blood transferred to the fetus?
O2 enters the intervillous space via the maternal arteries, to the villi then the
umbilical vein take the o2 blood to the fetus. The umbilical arteries take the deO2
blood from the baby through the villi and back to the mother
Diffusion
High to low concentration
Mom to fetus for O2
Low to high concentration for CO2 so baby to mom
,How is O2 transferred from mom to baby
Diffusion
What will ST-segment analysis tell you?
- Theoretically, ST-segment analysis of the fetal ECG provides continuous
information regarding the ability of the fetal heart to respond to stress in labor by
providing information about intracardiac responses to intrapartum hypoxia.
- Analysis of the ST segment may permit detection of myocardial ischemia and the
fetus' ability to respond to stress prior to peripheral organ and central nervous
system damage.
When do ST-segment and T-wave changes occur?
with myocardial ischemia, prior to permanent cell damage.
What are ST-segment and T-wave elevation indicative of?
fetus at risk of developing hypoxia but still capable of responding against
hypoxemia.
What are ST-segment and T-wave depression indicative of?
has been associated with the inability of the fetal heart to further respond to
hypoxia, indicating that the fetus either had no time to respond or has exhausted
compensatory mechanisms.
, When are fetal ST changes clinically relevant?
when they coincide with category 2 tracings
How do you differentiate an irregular heart rate from possible artifact or electronic
interference?
- auscultation
- ultrasound
- echocardiogram
- ecg
What is an arrhythmia?
- the sporadic, irregular beats typical of the frequent fetal events heard or recorded
on the tracing
- When there is a disturbance in the heart cell's ability to form and discharge an
impulse independently (automaticity & excitability), cardiac rhythm may become
tachycardic, bradycardic, or irregular with ectopic beats or premature rhythms such
as premature atrial contractions.
How are arrythmias categorized?
