4.        Management of fetal heart rate pattern changes
a.        Improving maternal circulation
b.        Improving fetal oxygenation
5.        Identification and management of variant fetal heart rate patterns
a.        Shoulders
b.        Overshoots
c.        Dysrhythmias
d.        Artifact
6.        FHR changes in response to common complications
a.        Preterm labor
b.        Hypertension
c.        Diabetes
d.        Multiple gestation
e.        Postdates pregnancy
f.        Bleeding disorders
g.        Infections
7.        Determination of fetal well being and oxygenation
a.        Uterine activity
b.        Variability
c.        Baseline rate
d.        Response to fetal stimulation
8.        Medical-legal responsibilities
a.        Midwifery practice guidelines
b.        Hospital policies
c.        State law
d.        Documentation
e.        Chain of command
9.        Case study presentations
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CERTIFICATION REVIEW BOOK FOR EFM NATIONAL
EXAM
(Pub: 2009, updated 2011)


Outline and Topics

1.        Physiology of blood flow
a.        Maternal systems
          1)        Respiratory
          2)        Cardiovascular
          3)        Reproductive (uterus)
b.        Fetal
          1)        Placenta
          2)        Umbilical cord
2.        Techniques of fetal assessment
a.        Auscultation
b.        Fetal movement counting
c.        Nonstress testing
d.        Contraction stress testing
e.        Biophysical profile
f.         Fetal stimulation
g.        External electronic monitoring
h.        Internal electronic monitoring
3.        NICHD pattern definitions
a.        Baseline
          1)        Normal
          2)        Tachycardia
          3)        Bradycardia
          4)        Sinusoidal
          5)        Indeterminate
b.        Periodic and episodic changes
          1)        Accelerations
          2)        Decelerations
                          a)        Early
                          b)        Late
                          c)        Variable
                          d)        Prolonged



Bibliography and Reference List

1.        American College of Obstetricians and Gynecologists (ACOG)(2008): Committee Opinion: Late-Preterm Infants. Number 404, April 2008.
2.        American College of Obstetricians and Gynecologists (ACOG)(1999): Antepartum Fetal Surveillance, Clinical Management Guidelines for Obstetrician-Gynecolog,
  Number 9, October 1999.
3.        Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) (2003): Fetal Heart Monitoring Principles and Practices, 3rd Edition.
4.        Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) (2008): Position Statement: Fetal Heart Monitoring.
5.        Gabbe, et al. (2007): Normal and Problem Pregnancies, Pub: Churchill Livingstone Elsevier.
6.        Macones, G, et al (2008): The 2008 National Institute of Child Health and Human Development Workshop Report on Electronic Fetal Monitoring: Update on Definitions,
  Interpretation, and Research Guidelines, JOGNN, 37, 510-515:2008.
7.        Menihan, C and Kopel, E (2007): Electronic Fetal Monitoring: Concepts and Applications. Pub: Lippincott.
8.        NCC Monograph (2006): Applying NICHD Terminology and Other Factors to Electronic Fetal Monitoring Interpretation, NCC, Volume 2, No. 1.
9.        Simpson, K and James, D (2008): Effects of Oxytocin-induced Uterine Hyperstimulation during Labor on Fetal Oxygen Status and Fetal Heart Rate Patterns; Am J Ob GYN,
   July 2008, p 34.e1-5.
10.      Tucker, Miller, and Miller (2008): Fetal Monitoring, A Multidisciplinary Approach, 6th Edition, Pub: Mosby.
This book has been designed for nurses, nurse midwives, and physicians who
have clinical experience with electronic fetal monitoring and plan to take a
national certification examination in fetal monitoring. Each chapter contains a
self-assessment examination with the answers in the final chapter. 2011
updated version contains a new chapter with EFM tracings with
questions/answers. Key points are highlighted within the text. It is a
spiral-bound book. Live courses based on this book are available by calling
401-261-4652, and have been approved for 16 hours of continuing education
time by the California Board of Registered Nursing (#15114) and the Florida
Board of Registered Nursing for Nurses and Advanced Nurse Practitioners.
FOR BULK ORDERING, PLEASE CALL 401-261-4652 TO INQUIRE ABOUT DISCOUNT.
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