NCC EFM Exam With Confidence Using Practice Dumps

Comprehensive and Detailed Explanation From Exact Extract–Based NCC C-EFM References:

This tracing shows recurrent late decelerations, decreased variability, and subtle baseline shifts—findings that strongly correspond to uteroplacental insufficiency. In trauma cases, NCC emphasizes that placental abruption is the most common fetal complication, caused by shearing forces separating the placenta from the uterine wall.

Key physiologic points per NCC/AWHONN/Menihan:

Maternal blunt abdominal trauma frequently leads to partial or concealed abruption.

Abruption produces decreased uteroplacental blood flow, resulting in:

Late decelerations

Minimal/absent variability

Baseline shifts or instability

Cord accident (option A) typically produces variable decelerations, not late-pattern decelerations.

Fetal trauma (option B) is extremely rare and does not produce a consistent deceleration pattern.

Thus, the physiology most consistent with this tracing and mechanism of injury is placental abruption.

Comprehensive and Detailed Explanation From NCC-Aligned Sources:

Both fetal tracings (A and B) show:

Baselines around 140–150 bpm

Moderate variability

Intermittent accelerations

No recurrent decelerations

Normal contraction pattern

Overall Category I patterns for both twins

NCC, NICHD, and AWHONN emphasize that moderate variability with a normal baseline is the strongest reassurance of fetal well-being, even in multifetal gestations.

There is no evidence of:

Tachysystole

Recurrent variables

Recurrent lates

Prolonged decelerations

Category III patterns

Therefore, the appropriate action is ongoing observation.

Why the incorrect answers are wrong:

A. Cesarean birth — Not indicated with Category I FHR patterns.

C. Terbutaline — Reserved for tachysystole or prolonged deceleration patterns, not present here.

Comprehensive and Detailed Explanation From NCC-Aligned Sources:

NICHD Category II includes:

Minimal variability

Marked variability

Absent accelerations without recurrent decelerations

Indeterminate baseline characteristics

A tracing with no accelerations and no decelerations becomes Category II if paired with marked variability, because marked variability indicates potential stress.

Why other answers are wrong:

A. FHR 110 bpm → normal baseline if variability normal.

B. Sinusoidal pattern → Category III, not Category II.

Correct answer: Marked variability.