CEFM Study Cards Questions and Answers All Correct
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Course
CEFM
Institution
CEFM
CEFM Study Cards Questions and Answers All Correct
Situations that may warrant an umbilical cord gas: - Answer- Abnormal/indeterminate FHR during labor
Low 5-min Apgar
Umbilical cord prolapse
Placental abruption
Thick meconium
Premature birth
Post-term birth
Severe IUGR
Multiple gestati...
CEFM Study Cards Questions and
Answers All Correct
Situations that may warrant an umbilical cord gas: - Answer- Abnormal/indeterminate
FHR during labor
Low 5-min Apgar
Umbilical cord prolapse
Placental abruption
Thick meconium
Premature birth
Post-term birth
Severe IUGR
Multiple gestation births
Uterine rupture
Maternal thyroid disease
Acute chorioamnionitis
Contraction Stress test: Negative - Answer- At least 3 contractions in 10 min
No late decels noted on tracing.
Contraction Stress test: Positive - Answer- > 50% of contractions in 10 min have late
decels of FHR associated with them.
Hospitalization is usually recommended.
Very low false-negative rate
Contraction Stress test: Unsatisfactory - Answer- Less than 3 contractions in 10 min
Inability to obtain FHR tracing
Repeat testing the following day.
Contraction Stress test: Equivocal/ Suspicious - Answer- < 50% of contractions have
late decels, variable decels, or prolonged decels of FHR associated with them.
Repeat testing the following day.
,Nonstress test: - Answer- The monitoring of FHR accels that occur in conjunction with
fetal movements
Usually performed 1-2x/week
False positives average around 50%.
If variable decels are noted during fetal movements, consider delivery.
Reactive - Answer- 2+ accels within 20 min
Accels must last 15 sec and peak 15 bpm above baseline.
For premature (< 32 weeks) infants, accels must last 10 sec and peak 10 bpm above
baseline.
Nonreactive - Answer- Must have 40 min continuous FHR monitoring
< 2 accels within any 20 min segment within the 40 min
Follow up with a stress test or BPP.
Biophysical Profile (BPP)Biophysical Profile (BPP) - Answer- Score: 0-10; score 8-10
indicate normal fetal variables
0 or 2 points are assigned to each of five components.
Used to determine fetal well-being via ultrasound (U/S)
May estimate fetal morbidity and mortality risk
Very low false-negative rate (high sensitivity)
Repeat BPP the following day for score of 6.
Consider hospitalization for scores < 6.
BPP/MBPP Scoring Chart: Amniotic Fluid Index (AFI) - Answer- 0: AFI < 5 cm and all
pockets < 2 cm
2: AFI ≥ 5 cm OR at least one pocket > 2 cm
BPP/MBPP Scoring Chart: Fetal Movements - Answer- 0: < 3 limb/trunk movements in
30 min
2: ≥ 3 limb/trunk movements in 30 min
BPP/MBPP Scoring Chart: Fetal Tone - Answer- 0: Slow or absent extension/flexion
2: ≥ 1 active extension/flexion; hand open/close is counted
BPP/MBPP Scoring Chart: Fetal Breathing - Answer- 0: < 30 sec of sustained fetal
breathing in 30 min
, 2: ≥ 1 episode of 30 sec sustained breathing in 30 min
BPP/MBPP: Pros - Answer- High sensitivity
May detect structural fetal anomalies
May be performed weekly
BPP/MBPP: Cons - Answer- Requires personnel trained in U/S and interpretation of
normal vs. abnormal fetal body parts
Requires more time to perform that other fetal well-being tests
Modified BPP Pros - Answer- Pros: eliminates need for personnel trained in fetal
visualization; sensitivity is higher than NST alone (lower false-negative rates)
Modified BPP Cons - Answer- Cons: may need to be performed more frequently (e.g.,
2x/week); may have higher false-positive rates than BPP (i.e., 60% vs 50%)
Modified biophysical profile (MBPP): - Answer- Combines the nonstress test with the
amniotic fluid index (AFI)
Decreases time and cost of BPP
Perform 2x/week.
If test is abnormal, use a back-up test (e.g., BPP, stress test) to reevaluate.
Modified Biophysical Profile (MBPP) - Answer- High sensitivity: has a similar low false-
negative rate to BPP
Modified Biophysical Profile (MBPP) - Answer- Low specificity: has a high false-positive
rate (~60%)
Amniotic fluid index (AFI): Definition - Answer- "...sum of the deepest vertical cord-free
pockets of amniotic fluid in each of the four uterine quadrants." (Miller, et al., 2013)
Amniotic Fluid Index (AFI) pockets are measured - Answer- in cm
AFI- how often? - Answer- Perform 1x/week before 41 weeks gestation, if other fetal
variables are normal and AFI remains > 8 cm.
After 41 weeks, perform 2x/week and monitor for oligohydramnios.
AFI Findings - Answer- Hydramnios: > 25 cm
High-normal: 25 cm
Normal: at least 10 cm
Low-normal: between 5-10 cm
Oligohydramnios: < 5 cm (always considered abnormal regardless of NST results when
performing the MBPP)
Fetal Movement Counting - Answer- Based on the theory that fetal movements
decrease in inverse proportion with increasing fetal hypoxemia
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