CJE MATERNITY REVIEW
PART 2 - COMPREHENSIVE
STUDY GUIDE
SECTION 1: CONTRACTION STRESS TEST (CST)
QUESTION 1
What is a Contraction Stress Test (CST)?
ANSWER
A test that checks your baby for signs of stress during uterine contractions.
During the test:
• Mother is given a hormone that makes the uterus contract
• Contractions are similar to labor but typically don't start labor
• Specifically looks for LATE DECELERATIONS in response to contractions
RATIONALE / EXPLANATION
The CST evaluates how the fetus will respond to the stress of labor by monitoring for late
decelerations, which indicate uteroplacental insufficiency.
QUESTION 2
What is required to perform a Contraction Stress Test?
ANSWER
• NOT a routine test for every patient
• Is an INVASIVE test
• Requires INFORMED CONSENT
• Requires CONTINUOUS fetal monitoring
• Drug required: OXYTOCIN or NIPPLE STIMULATION to elicit contractions
RATIONALE / EXPLANATION
Informed consent is required because the test carries risks including preterm labor. Continuous
monitoring is essential to detect fetal distress.
Page 1 of 21
,QUESTION 3
What is the goal of the Contraction Stress Test?
ANSWER
To see if the mother and fetus can withstand the process of labor.
The test will:
• Ensure the client has contractions
• Observe if late decelerations occur
• Determine if there is evidence of uteroplacental insufficiency
RATIONALE / EXPLANATION
If late decelerations occur, it suggests the placenta cannot adequately oxygenate the fetus during
contractions, meaning labor may not be tolerated.
QUESTION 4
What are the contraindications for a Contraction Stress Test? (Part 1)
ANSWER
• Abnormal fetal position (malposition) - breech, transverse, posterior
• Fetal prematurity (preterm) - 37 weeks or less
• Fetal head not engaged (not at zero station)
• Cephalopelvic disproportion (fetus head too large for maternal pelvis)
• Multigestation (twins, triplets, etc.)
RATIONALE / EXPLANATION
These conditions make vaginal delivery unlikely or dangerous, so testing labor tolerance is
contraindicated.
QUESTION 5
What are the contraindications for a Contraction Stress Test? (Part 2)
ANSWER
• Any obstetrical emergency situation
• Placenta previa/abruption, vasa previa
• Previous surgery to uterus or cervix (including 2+ C-sections)
• History of uterine surgery or fibroids
Page 2 of 21
, • Classic uterine vertical incision
• Active genital herpes infection
RATIONALE / EXPLANATION
These conditions increase risk of uterine rupture, hemorrhage, or neonatal infection with
contractions.
QUESTION 6
How is a Contraction Stress Test interpreted?
ANSWER
NEGATIVE (Normal) = PASSED:
• No late decelerations occurred
• Good result
POSITIVE (Abnormal) = FAILED:
• Late decelerations occurred
• Concerning result - fetus may not tolerate labor
RATIONALE / EXPLANATION
Remember: Negative is GOOD (no bad signs). Positive means there IS a problem (late decels
present).
QUESTION 7
What interventions are required for a NEGATIVE CST?
ANSWER
• Document the findings as normal
• Observe for 30 minutes after to ensure contractions have stopped
RATIONALE / EXPLANATION
A negative result is reassuring. Observation ensures oxytocin effects have worn off before
discharge.
QUESTION 8
What interventions are required for a POSITIVE CST?
Page 3 of 21
PART 2 - COMPREHENSIVE
STUDY GUIDE
SECTION 1: CONTRACTION STRESS TEST (CST)
QUESTION 1
What is a Contraction Stress Test (CST)?
ANSWER
A test that checks your baby for signs of stress during uterine contractions.
During the test:
• Mother is given a hormone that makes the uterus contract
• Contractions are similar to labor but typically don't start labor
• Specifically looks for LATE DECELERATIONS in response to contractions
RATIONALE / EXPLANATION
The CST evaluates how the fetus will respond to the stress of labor by monitoring for late
decelerations, which indicate uteroplacental insufficiency.
QUESTION 2
What is required to perform a Contraction Stress Test?
ANSWER
• NOT a routine test for every patient
• Is an INVASIVE test
• Requires INFORMED CONSENT
• Requires CONTINUOUS fetal monitoring
• Drug required: OXYTOCIN or NIPPLE STIMULATION to elicit contractions
RATIONALE / EXPLANATION
Informed consent is required because the test carries risks including preterm labor. Continuous
monitoring is essential to detect fetal distress.
Page 1 of 21
,QUESTION 3
What is the goal of the Contraction Stress Test?
ANSWER
To see if the mother and fetus can withstand the process of labor.
The test will:
• Ensure the client has contractions
• Observe if late decelerations occur
• Determine if there is evidence of uteroplacental insufficiency
RATIONALE / EXPLANATION
If late decelerations occur, it suggests the placenta cannot adequately oxygenate the fetus during
contractions, meaning labor may not be tolerated.
QUESTION 4
What are the contraindications for a Contraction Stress Test? (Part 1)
ANSWER
• Abnormal fetal position (malposition) - breech, transverse, posterior
• Fetal prematurity (preterm) - 37 weeks or less
• Fetal head not engaged (not at zero station)
• Cephalopelvic disproportion (fetus head too large for maternal pelvis)
• Multigestation (twins, triplets, etc.)
RATIONALE / EXPLANATION
These conditions make vaginal delivery unlikely or dangerous, so testing labor tolerance is
contraindicated.
QUESTION 5
What are the contraindications for a Contraction Stress Test? (Part 2)
ANSWER
• Any obstetrical emergency situation
• Placenta previa/abruption, vasa previa
• Previous surgery to uterus or cervix (including 2+ C-sections)
• History of uterine surgery or fibroids
Page 2 of 21
, • Classic uterine vertical incision
• Active genital herpes infection
RATIONALE / EXPLANATION
These conditions increase risk of uterine rupture, hemorrhage, or neonatal infection with
contractions.
QUESTION 6
How is a Contraction Stress Test interpreted?
ANSWER
NEGATIVE (Normal) = PASSED:
• No late decelerations occurred
• Good result
POSITIVE (Abnormal) = FAILED:
• Late decelerations occurred
• Concerning result - fetus may not tolerate labor
RATIONALE / EXPLANATION
Remember: Negative is GOOD (no bad signs). Positive means there IS a problem (late decels
present).
QUESTION 7
What interventions are required for a NEGATIVE CST?
ANSWER
• Document the findings as normal
• Observe for 30 minutes after to ensure contractions have stopped
RATIONALE / EXPLANATION
A negative result is reassuring. Observation ensures oxytocin effects have worn off before
discharge.
QUESTION 8
What interventions are required for a POSITIVE CST?
Page 3 of 21
