Comprehensive and Detailed Explanation From Exact Extract without any URL or Links
According to the NCC C-EFM 2025 Candidate Guide, Pattern Recognition and Intervention requires the candidate to classify fetal heart rate (FHR) patterns using the NICHD 2008 three-tier system, which NCC endorses across all recommended resources (AWHONN Fetal Heart Monitoring Principles and Practices, Menihan Electronic Fetal Monitoring, Simpson & Creasy, Miller’s Pocket Guide).
A Category II tracing is defined as “indeterminate” and includes any FHR pattern that is not Category I and not Category III. NCC references indicate that Category II may include:
Minimal or marked variability
Absence of accelerations after fetal stimulation
Recurrent variable decelerations with moderate variability
Prolonged decelerations lasting 2–10 minutes
Baseline tachycardia or bradycardia without absent variability
In the tracing provided:
The baseline FHR is approximately 135–145 bpm, within normal limits.
Moderate variability is not consistently present; variability is borderline minimal–moderate at times.
No significant accelerations are seen over the 25-minute evaluation period.
No recurrent late or prolonged decelerations are present.
There are occasional subtle variable-type dips, but not enough to meet criteria for Category III.
NCC-endorsed texts (such as AWHONN and Menihan) state that a tracing with minimal variability for less than 40 minutes and without recurrent decelerations is Category II, as it fails to meet the requirements for Category I (must have moderate variability and accelerations absent decelerations) and lacks the criteria for Category III (must have absent variability with recurrent late decels, recurrent variable decels, bradycardia, or sinusoidal pattern).
Therefore, this pattern is indeterminate, consistent with Category II, and requires continued surveillance and evaluation, which aligns with NCC-recommended clinical decision-making competencies.
