CMA Fetal Monitoring & Assessment 1 — Questions and Answers
Question 1: What is the normal baseline fetal heart rate (FHR) range according to NICHD guidelines?
- 80–100 bpm
- 110–160 bpm (Correct answer)
- 160–180 bpm
- 60–80 bpm
Correct answer: 110–160 bpm
The normal baseline FHR is 110–160 bpm; values outside this range indicate bradycardia or tachycardia requiring further evaluation.
Question 2: Which device uses Doppler ultrasound to detect fetal heart movement at the bedside?
- Fetoscope
- Handheld Doppler (Doppler fetoscope) (Correct answer)
- Amniocentesis needle
- Biophysical profile transducer
Correct answer: Handheld Doppler (Doppler fetoscope)
A handheld Doppler device emits and receives ultrasound waves to detect fetal cardiac movement, making it the standard bedside tool.
Question 3: A non-stress test (NST) primarily evaluates fetal well-being by assessing:
- Fetal lung maturity via lecithin/sphingomyelin ratio
- Fetal heart rate response to uterine contractions
- FHR accelerations associated with fetal movement (Correct answer)
- Placental function via estriol levels
Correct answer: FHR accelerations associated with fetal movement
An NST is reactive when fetal movement triggers FHR accelerations, indicating an intact autonomic nervous system and adequate oxygenation.
Question 4: For a full-term pregnancy, a reactive NST requires at least how many accelerations within 20 minutes?
- 1 acceleration of 10 bpm lasting 10 seconds
- 2 accelerations of 15 bpm lasting 15 seconds (Correct answer)
- 3 accelerations of 20 bpm lasting 20 seconds
- 4 accelerations of 10 bpm lasting 5 seconds
Correct answer: 2 accelerations of 15 bpm lasting 15 seconds
A reactive NST at ≥32 weeks requires at least 2 accelerations of ≥15 bpm above baseline, each lasting ≥15 seconds, within a 20-minute window.
Question 5: Which assessment is considered the gold standard for evaluating fetal acid-base status intrapartum?
- Non-stress test
- Biophysical profile
- Fetal scalp blood sampling (Correct answer)
- Contraction stress test
Correct answer: Fetal scalp blood sampling
Fetal scalp blood sampling directly measures fetal pH and lactate, providing the most accurate assessment of fetal acid-base status.
Question 6: A biophysical profile (BPP) assesses fetal well-being using which combination of parameters?
- FHR, maternal BP, AFI, fetal weight, placental grade
- Fetal breathing, gross movement, tone, AFI, and NST (Correct answer)
- Fetal position, presentation, station, dilation, effacement
- FHR variability, decelerations, accelerations, contractions, maternal O2
Correct answer: Fetal breathing, gross movement, tone, AFI, and NST
The BPP evaluates five components — fetal breathing movements, gross body movements, tone, amniotic fluid index, and NST — each scored 0 or 2.
Question 7: Early decelerations on an electronic fetal monitor are caused by which mechanism?
- Umbilical cord compression
- Fetal head compression during contractions (Correct answer)
- Uteroplacental insufficiency
- Fetal hypoxia
Correct answer: Fetal head compression during contractions
Early decelerations mirror contractions and result from vagal stimulation due to fetal head compression; they are benign and require no intervention.
CMA Fetal Monitoring & Assessment 1
What is the normal baseline fetal heart rate (FHR) range according to NICHD guidelines?