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

Which FHR pattern is likely to develop with severe fetal anemia?

1. Variability absent

2. Sinusoidal pattern

3. Bradycardia

4. Accelerated pattern

The correct answer is: Sinusoidal pattern

The sinusoidal pattern is characterized by a smooth, wave-like appearance in the fetal heart rate (FHR) tracing and is often associated with severe fetal anemia. This pattern reflects a specific type of fetal response to conditions that create significant stress, such as reduced blood volume or inadequate oxygenation. In cases of severe fetal anemia, the fetus may experience hypoxia and fetal distress, leading to an abnormal response in heart rate regulation. The sinusoidal pattern emerges as the body attempts to maintain oxygen delivery to vital organs, resulting in the characteristic oscillations typically seen in the tracing. Understanding this, it becomes clear why other patterns are less likely to occur. For example, absent variability indicates a different type of fetal distress where fluctuations in heart rate are minimal or non-existent, suggesting a more static or dire situation. On the other hand, bradycardia signifies a slower than normal heart rate but does not specifically indicate anemia; it's a broader sign of possible distress. Lastly, an accelerated pattern usually indicates a well-oxygenated fetus responding positively to stimuli, which would be inconsistent with the conditions caused by severe fetal anemia. In summary, the sinusoidal pattern is a specific response to severe fetal anemia, reflecting the fetus's effort to cope with a critical state