Interpretation of Electronic Fetal Heart Rate (EFHR) patterns, as the major component of the non stress test (NST) and contraction stress test(CST), is a required skill for prenatal and delivery care. However, there are situations where the fetal heart rate tracing may be misleading.1 Because the decision to perform emergency cesarean section frequently hinges on (EFHR) monitoring, it is important to recognize situations where EFHR monitoring could be misleading.