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

Which FHR pattern would be anticipated when monitoring mono-mono twins?

1. Early Decels

2. Variable Decels

3. Late Decels

4. Normal Baseline

The correct answer is: Variable Decels

When monitoring mono-mono twins, the anticipated fetal heart rate (FHR) pattern that is most commonly observed is variable decelerations. This pattern occurs due to the close confinement of the twins within the same amniotic sac, which increases the risk of umbilical cord compression as the fetuses move and interact with one another. Variable decelerations are characterized by abrupt decreases in the fetal heart rate that can vary in duration and intensity, typically reflecting transient periods of fetal hypoxia or compromised blood flow resulting from cord compression. The presence of variable decels in mono-mono twins highlights the significance of continuous monitoring, as these fluctuations can provide critical insights into the welfare of the fetuses and the need for potential intervention or closer observation. In contrast, other FHR patterns such as early or late decelerations indicate different underlying issues generally linked to uterine contractions or placental insufficiency. Normal baseline heart rate, while desirable, does not specifically indicate the unique risks associated with the shared environment of mono-mono twins. Thus, the occurrence of variable decelerations is key in this context, illustrating the specific challenges faced in monitoring this twin gestation scenario.