EFM EFM - Electronic Fetal Monitoring Special Populations and High-Risk Conditions Questions and Answers

Question 1

In a preterm fetus at 28 weeks gestation, which FHR characteristic differs from a term fetus and must be considered during EFM interpretation?

Accepted Answer

Higher baseline heart rate and less pronounced variability are normal for gestational age

Answer

Accelerations must meet the same 15×15 criteria as a term fetus

Answer

Late decelerations are expected and acceptable

Answer

Bradycardia below 100 bpm is normal before 30 weeks

Question 2

When monitoring a patient with gestational diabetes on EFM, which fetal heart rate concern is MOST associated with macrosomia and shoulder dystocia risk?

Accepted Answer

Prolonged second-stage decelerations indicating head compression with risk of cord entrapment at delivery

Answer

Persistent sinusoidal pattern

Answer

Baseline tachycardia above 180 bpm throughout labor

Answer

Absence of accelerations in the first stage

Question 3

In a twin gestation monitored with EFM, what is a major challenge unique to dual fetal monitoring?

Accepted Answer

Signal cross-capture where one transducer picks up the other twin's heart rate

Answer

The inability to detect uterine contractions with an external tocometer

Answer

Baseline FHR is always identical for both twins

Answer

Only twin A can be monitored electronically

Question 4

Which fetal heart rate pattern is MOST concerning in a patient with severe preeclampsia?

Accepted Answer

Late decelerations with minimal variability

Answer

Accelerations with moderate variability

Answer

Early decelerations only

Answer

Mild variable decelerations with quick recovery

Question 5

A patient at 41 weeks gestation is being monitored with EFM during oxytocin induction. Which pattern specifically increases risk in post-term fetuses?

Accepted Answer

Variable decelerations due to oligohydramnios increasing cord compression risk

Answer

Moderate variability indicating fetal reserve

Answer

Accelerations confirming fetal well-being

Answer

Early decelerations from head compression

Question 6

During EFM of a patient with intrauterine growth restriction (IUGR), which finding suggests the fetus has exhausted its compensatory reserves?

Accepted Answer

Absent or minimal baseline variability with repetitive late decelerations

Answer

Moderate variability with occasional accelerations

Answer

Early decelerations with normal baseline

Answer

Increased fetal movement with reactive non-stress test