WorksheetsIntrapartum Fetal Monitoring MCQs (NICE Guidelines)
Total questions: 10
Worksheet time: 5mins
A 31-year-old G1P0 at 40 weeks' gestation is in active labor. Her cervical exam is 5 cm. The CTG shows a baseline heart rate of 165 bpm, moderate variability (15 bpm), and no decelerations. Accelerations are present. According to the NICE guidelines, how should this CTG be classified?
Normal
Suspicious
Pathological
Abnormal
Indeterminate
A 28-year-old at 39 weeks' gestation has a CTG displaying a baseline of 140 bpm and variability of <5 bpm that has persisted for 45 minutes. No decelerations are noted. What is the correct classification for this specific feature of variability?
Stable
Non-reassuring
Abnormal
Normal
Sinusoidal
A G2P1 at 41 weeks' gestation is undergoing oxytocin augmentation. The CTG shows a baseline of 150 bpm, variability of 10 bpm, and late decelerations occurring with over 50% of contractions for the last 35 minutes. What is the most appropriate immediate management step?
Perform immediate Cesarean delivery
Discontinue the oxytocin infusion
Perform fetal blood sampling (FBS)
Increase maternal IV fluid rate
Apply a fetal scalp electrode
A resident is reviewing the CTG of a patient at 33 weeks' gestation with suspected placental abruption. The CTG is pathological with recurrent late decelerations and reduced variability. Which of the following is an absolute contraindication to performing fetal blood sampling in this patient?
Maternal BMI >35
Gestation less than 34 weeks
Previous Cesarean section
Cervical dilatation of 3 cm
Maternal pyrexia
Fetal blood sampling is performed for a pathological CTG in a woman at 39 weeks' gestation. The result shows a scalp blood lactate of 4.5 mmol/L. According to NICE, what is the most appropriate next step?
Perform an immediate Cesarean delivery
Repeat the FBS in 30–60 minutes
Inform the patient that the result is normal
Perform fetal scalp stimulation
Discontinue all monitoring
A CTG demonstrates variable decelerations. Which of the following characteristics would lead to these decelerations being classified as having "concerns" according to the NICE criteria?
Duration of 30 seconds
Reduced variability within the deceleration
Rapid return to the baseline heart rate
Presence of 'shoulders' (accelerations before and after)
Uniform V-shaped appearance
During the second stage of labor, a patient's CTG becomes pathological with a prolonged deceleration lasting 4 minutes. The fetal head is at station +2, and the mother is fully dilated. What is the most appropriate management?
Perform fetal blood sampling
Proceed with immediate operative vaginal delivery
Perform an emergency Cesarean section
Ask the mother to stop pushing and reassess
Wait for 5 more minutes to see if the heart rate recovers
A CTG shows a smooth, sine-wave-like undulating pattern with a frequency of 3–5 cycles per minute and an amplitude of 10 bpm, persisting for over 25 minutes. How should this be categorized according to NICE?
Normal
Suspicious
Pathological
Benign
Early Deceleration
Which physiological mechanism is primarily responsible for the development of late decelerations in the presence of uteroplacental insufficiency?
Vagal stimulation via fetal head compression
Baroreceptor response to umbilical cord occlusion
Chemoreceptor response to fetal hypoxemia
Direct myocardial depression from severe acidemia
Increased intracranial pressure causing a Cushing reflex
A woman at 40 weeks' gestation has a suspicious CTG with a baseline of 165 bpm. There are 6 contractions in 10 minutes. What is the most appropriate first-line action?
Perform a Cesarean section
Reduce or stop oxytocin and reassess
Administer IV oxytocin bolus
Start an IV infusion of magnesium sulfate
Perform fetal blood sampling
