EFM - Electronic Fetal Monitoring FHR Pattern Tier Interpretation Questions and Answers

Question 1

An EFM tracing shows a baseline FHR of 135 bpm, moderate variability, accelerations with fetal movement, and no decelerations.
According to the NICHD three-tier system, how should this pattern be categorized?

Accepted Answer

Category I

Answer

Category II

Answer

Category III

Answer

Uninterpretable

Question 2

Which of the following FHR patterns is classified as a Category III tracing?

Accepted Answer

Absent variability with recurrent late decelerations

Answer

Moderate variability with recurrent late decelerations

Answer

Fetal tachycardia with minimal variability

Answer

A prolonged deceleration lasting 4 minutes

Question 3

A 20-minute EFM strip shows a baseline FHR of 170 bpm. Variability is minimal (amplitude range of 3-5 bpm). There are no accelerations or decelerations. Based on the three-tier FHR interpretation system, this tracing should be classified as:

Accepted Answer

Category II

Answer

Category I

Answer

Category III

Answer

Normal variant

Question 4

A clinician has classified a fetal heart rate tracing as Category II. Which of the following findings, on its own, would be consistent with this classification?

Accepted Answer

Marked variability

Answer

Moderate variability with no decelerations

Answer

Sinusoidal pattern

Answer

Absent variability with recurrent variable decelerations

Question 5

An EFM tracing shows a baseline of 125 bpm. Over the last 30 minutes, there have been recurrent late decelerations. However, variability has remained moderate throughout this period. What is the correct interpretation of this FHR pattern?

Accepted Answer

Category II, due to the recurrent late decelerations with moderate variability.

Answer

Category I, as variability is moderate.

Answer

Category III, as any recurrent late deceleration is abnormal.

Answer

Category I, because the baseline is normal.

Question 6

What is the primary goal of classifying a fetal heart rate tracing into one of the three tiers?

Accepted Answer

To provide a standardized framework for communication and guide clinical action based on the predicted fetal acid-base status.

Answer

To diagnose the specific cause of fetal distress.

Answer

To predict the exact Apgar scores at birth.

Answer

To determine the precise timing for an amnioinfusion.