Comprehensive and Detailed Explanation From NCC-Aligned Sources:
This tracing shows:
Baseline approximately 135–140 bpm
Minimal variability
No accelerations
No recurrent decelerations
Category II for 20 minutes
According to NCC, AWHONN, and NICHD, minimal variability persisting ≥ 20 minutes without accelerations requires assessment of fetal acid-base status, and fetal scalp stimulation is an accepted method to evaluate fetal well-being when a Category II tracing persists.
Fetal scalp stimulation:
Should produce an acceleration ≥ 15 bpm lasting ≥ 15 seconds
A positive response indicates intact fetal nervous system and normal pH
If no acceleration occurs → further intrauterine resuscitation or expedited delivery may be required
Why other options are incorrect:
A. Delivery — Not indicated; this is Category II, not Category III.
C. IV bolus — IV hydration may improve variability, but assessment of fetal status comes first after 20 minutes of minimal variability.
Thus, the correct answer is B. Fetal scalp stimulation.
[References:NCC C-EFM Candidate Guide; AWHONN FHMPP; NICHD Three-Tier System; Menihan; Miller’s Pocket Guide; Simpson & Creehan., , ]
