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Electronic Fetal Monitoring Exam Review

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Course Description

This course will review test content outline and the associated competencies to prepare for the 2020 NCC subspecialty examination in Electronic Fetal Monitoring. Content will include fetal heart monitoring (FHM) pattern recognition and interpretation using NICHD definitions; review of the physiology of maternal fetal oxygenation and other factors impacting on the neuromodulation of fetal heart rate, complications of labor and the potential effects on FHM data; review interventions and management targeted to the physiology of FHR patterns. Content will be applied in the context of case studies. Adjunct fetal assessment, legal aspects of FHM and equipment troubleshooting will be reviewed.

Program Learning Outcomes

This program prepares the learner to:

  • Apply NICHD terminology to fetal heart rate pattern recognition, interpretation and assessment.
  • Discuss factors affecting fetal oxygenation, including fetal heart rate regulation; maternal and fetal physiology; complications of pregnancy and labor, drug effects and dysrhythmias.
  • Use knowledge of the advantages and disadvantages of electronic fetal monitoring to provide information to the pregnant woman and her support person(s).
  • Review appropriate nursing interventions and actions targeted to the physiology of the FHM patterns.
  • Discuss adjunct fetal assessment, including fetal acid base interpretation and the biophysical profile.
  • Incorporate knowledge of legal responsibilities and liabilities related to FHM data into a plan of care.


Sign-in begins at 7:30 am. The day includes a one-hour lunch (on your own), as well as a morning and afternoon break of 15 minutes each. The order of lectures presented and break times may vary according to speaker preference.

8:00 am to 4:30 pm

  • Welcome and Overview
  • About the Test, Test-Taking Skills
    Common Strategies | Recommended Practices for Preparation | Methods to Reduce Anxiety
  • Equipment Overview and Patient Education
    Appearance of Artifact and Equipment Failure/Troubleshooting for Electronic Monitors | Elements of Patient Consent, Education and Application of EFM
  • Physiology of Fetal Oxygenation: Extrinsic Factors
    Maternal Factors Affecting Fetal Oxygenation | Effects of Uterine Activity on Placental Circulation and Fetal Oxygenation
  • Physiology of Fetal Oxygenation: Intrinsic Factors
    Fetal Cardio Regulatory Mechanism and Effects on Heart Rate | Effects of Baroreceptors, Chemoreceptors and Hormonal Influences on Fetal Heart Rate Regulation
  • Pattern Recognition, Interpretation and Intervention
    Labeling FHR Patterns with Appropriate NICHD Terminology | NICHD Classification of FHR Patterns and Implications for Care
  • Complications of Pregnancy and Birth
    Implications for Complications of Birth on FHR Patterns | Preterm Patterns | Hypertensive Disorders | Post-date Pregnancy | Diabetes | Infections | Multifetal Pregnancy
  • Dysrhythmias and Variant Patterns
    Identifying FHR Dysrhythmias Based on Pattern Recognition
  • Adjunct Fetal Assessment
    Auscultation | Fetal Movement Counting | Contraction Stress Testing | Biophysical Profile | Fetal Cord Blood Acid Base Results
  • Professional Practice Issues and Key Point Review
  • Questions, Course Wrap-Up and Evaluations