|FETAL MONITORING CERTIFICATION REVIEW COURSE
Approved for 16 hours CE time by ACNM 2010/095, and for 16 hours
by both the FL Board of Registered Nursing and
California Board of Registered Nursing
Kent Hospital, March 24 and 25, 2013
Repeated April 4 and 5, 2013
Course Length each day: Eight hours/day = 480 minutes
Teaching Delivery Method: Lecture with audience participation and self-
By the completion of the course, each participant should be able to:
1. List the six physiologic mechanisms in which oxygen flow to the fetus may
2. Define the differences between metabolic and respiratory acidosis.
3. Describe the link between antepartum and intrapartum events and
cerebral palsy based on current literature.
4. Define fetal heart rate accelerations, decelerations, and baseline
changes utilizing the National Institute of Child Health and Development Task
5. Define uterine activity assessment utilizing the National Institute of Child
Health and Development Task Force (2008).
6. Define the categories of patterns as defined by the National Institute of
Child Health and Development Task Force (2008).
7. List possible EFM pattern changes and appropriate interventions in
response to common complication.
8. Discuss adjunct fetal assessment techniques used to assess fetal well
9. Discuss the implications and importance of documentation, standards of
care, and hospital policies.
Content Outline and Topics
1. Physiology of blood flow
a. Maternal systems
3) Reproductive (uterus)
2) Umbilical cord
2. Techniques of fetal assessment
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
b. Periodic and episodic changes
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
6. FHR changes in response to common complications
a. Preterm labor
d. Multiple gestation
e. Postdates pregnancy
f. Bleeding disorders
7. Determination of fetal well being and oxygenation
a. Uterine activity
c. Baseline rate
d. Response to fetal stimulation
8. Medical-legal responsibilities
a. Midwifery practice guidelines
b. Hospital policies
c. State law
e. Chain of command
9. Case study presentations
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-Gynecologists, Number 9, October 1999.
3. Gabbe, et al. (2007): Normal and Problem Pregnancies, Pub: Churchill
4. 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,
5. Menihan, C and Kopel, E (2007): Electronic Fetal Monitoring: Concepts
and Applications. Pub: Lippincott.
6. NCC Monograph (2006): Applying NICHD Terminology and Other Factors
to Electronic Fetal Monitoring Interpretation, NCC, Volume 2, No. 1.
7. 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.
8. Tucker, Miller, and Miller (2008): Fetal Monitoring, A Multidisciplinary
Approach, 6th Edition, Pub: Mosby.
|The purpose of this course is to prepare nurses,
nurse midwives and physicians for the national
certification examination in electronic fetal
monitoring by reviewing key components that are
pertinent to the application of EFM to clinical
This one or two-day course has been approved by the California and Florida Boards of
Registered Nursing for nurses and advanced-practice nurses for 8 hours/day of credit
and The American College of Nurse Midwives (#2009/008). The two-day course is
recommended for maximum coverage of material.
Please call 401-261-4652 if you are interested in hosting this course at your hospital or
if you would like other information about locations and dates of offering. It can be offered
as either a one-day seminar or two-day complete program.