NCC Certified Electronic Fetal Monitoring (C-EFM) Practice Exam

Which factor is least likely to impact the assessment of fetal heart rate during labor?

1. Maternal position

2. Time of day

3. External stressors

4. Gestational age

The correct answer is: Time of day

The assessment of fetal heart rate during labor is influenced by several factors, but the time of day is the least likely to have a direct impact. Maternal position plays a crucial role in how the fetal heart rate is monitored because certain positions can affect uteroplacental blood flow and, subsequently, the fetal heart rate patterns. For instance, lying supine can lead to compression of the inferior vena cava, which may affect blood flow and oxygen delivery to the fetus, hence altering the fetal heart rate. External stressors, such as maternal anxiety, pain, and environmental noise, can also impact fetal heart rate assessment. Stress can lead to physiological changes that may be reflected in the fetal heart rate patterns, making this a significant factor during labor. Gestational age is important in assessing fetal heart rate because it influences the maturity of the fetal nervous system and its ability to regulate heart rate. Different gestational ages may exhibit different heart rate variability and characteristics, which can be critical information during labor. In contrast, the time of day does not typically affect the physiological aspects of fetal heart rate assessment. While it may contribute to the overall context of care (such as staffing levels or alertness of healthcare providers), it does not have a direct influence on the fetal