FETAL HEALTH SURVEILLANCE EXAM
QUESTIONS AND ANSWERS GRADED A+
2026
Level-I Evidence - ANS At Least one proper randomized controlled trial
Level-II1 - ANS Well-designed controlled trials without randomization
Level-II2 - ANS Well-designed cohort or case-control analytic studies
Level-II3 - ANS Comparisons between times or places with or without the intervention
Level-III - ANS Opinions of respected authorities, clinical experience, descriptive studies or
expert committees
Levels, A, B, C, D, E, I - ANS A: Good evidence to recommend; B: Fair evidence to recommend;
C: Evidence is conflicting and does not allow a recommendation; D: Fair evidence to recommend
against; E: Good evidence to recommend against; I: Insufficient evidence to make
recommendations
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
1
, Supportive Care Recommendation - ANS SOGC FHS Consensus Guideline states
(Recommendation 7), "Women in active labour should receive continuous close support from
an appropriately trained person" (I-A)
What does labour support decrease? - ANS Use of pain medication, use of regional
analgesia/anesthesia, use of operative vaginal birth, cesarean births, episiotomy rates,
dissatisfaction with the birth experience and length of labour
Why do we monitor the fetus during labour? - ANS We monitor the fetus because fetal
oxygenation is affected by maternal oxygenation, utero-placental blood flow, and blood flow
from the placenta through the cord, and the distribution of oxygen in fetal tissues. During
contractions, the uteroplacental blood flow is reduced, and therefore oxygen exchange to the
fetus is reduced.
What is the goal of fetal surveillance? - ANS To detect potential fetal decompensation and
allow time for interventions to prevent perinatal or neonatal morbidity or mortality.
Is Cerebral Palsy caused by Intrapartum Events? - ANS No evidence to indicate that EFM
reduces CP, but there are some situations where intrapartum hypoxia may be associated with
CP. Short term hypoxia will not usually result in CP.
The likelihood of a hypoxic event resulting in long-term sequelae is dependent upon the nature
and duration of the insult and the vulnerability of the fetus.
What are the four criteria that are essential to consider a relationship between intrapartum
asphyxia and CP? - ANS - Evidence of metabolic acidosis in the umbilical cord arterial blood at
delivery: pH<7, base deficit greater or equal to 12 mmol/L
- Early onset or severe to moderate neonatal encephalopathy in infant born at or beyond 34
weeks
- CP of the spastic quadriplegic or dyskinetic type
- Exclusion of other identifiable etiologies
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
2
QUESTIONS AND ANSWERS GRADED A+
2026
Level-I Evidence - ANS At Least one proper randomized controlled trial
Level-II1 - ANS Well-designed controlled trials without randomization
Level-II2 - ANS Well-designed cohort or case-control analytic studies
Level-II3 - ANS Comparisons between times or places with or without the intervention
Level-III - ANS Opinions of respected authorities, clinical experience, descriptive studies or
expert committees
Levels, A, B, C, D, E, I - ANS A: Good evidence to recommend; B: Fair evidence to recommend;
C: Evidence is conflicting and does not allow a recommendation; D: Fair evidence to recommend
against; E: Good evidence to recommend against; I: Insufficient evidence to make
recommendations
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
1
, Supportive Care Recommendation - ANS SOGC FHS Consensus Guideline states
(Recommendation 7), "Women in active labour should receive continuous close support from
an appropriately trained person" (I-A)
What does labour support decrease? - ANS Use of pain medication, use of regional
analgesia/anesthesia, use of operative vaginal birth, cesarean births, episiotomy rates,
dissatisfaction with the birth experience and length of labour
Why do we monitor the fetus during labour? - ANS We monitor the fetus because fetal
oxygenation is affected by maternal oxygenation, utero-placental blood flow, and blood flow
from the placenta through the cord, and the distribution of oxygen in fetal tissues. During
contractions, the uteroplacental blood flow is reduced, and therefore oxygen exchange to the
fetus is reduced.
What is the goal of fetal surveillance? - ANS To detect potential fetal decompensation and
allow time for interventions to prevent perinatal or neonatal morbidity or mortality.
Is Cerebral Palsy caused by Intrapartum Events? - ANS No evidence to indicate that EFM
reduces CP, but there are some situations where intrapartum hypoxia may be associated with
CP. Short term hypoxia will not usually result in CP.
The likelihood of a hypoxic event resulting in long-term sequelae is dependent upon the nature
and duration of the insult and the vulnerability of the fetus.
What are the four criteria that are essential to consider a relationship between intrapartum
asphyxia and CP? - ANS - Evidence of metabolic acidosis in the umbilical cord arterial blood at
delivery: pH<7, base deficit greater or equal to 12 mmol/L
- Early onset or severe to moderate neonatal encephalopathy in infant born at or beyond 34
weeks
- CP of the spastic quadriplegic or dyskinetic type
- Exclusion of other identifiable etiologies
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
2
