Factors of development and methods of treatment of fetal bradycardia. Fetal bradycardia: causes, symptoms and treatment

For a certain period of pregnancy, there is a norm for the baby’s heart rate. Fetal bradycardia in early pregnancy leads to complications of intrauterine development.

The baby's heart rate (HR) should be normal. Going beyond these limits poses a threat to further intrauterine development. Fetal bradycardia in the early stages of pregnancy is diagnosed less frequently than in the later stages. Therefore, constant monitoring using ultrasound becomes important during the management of intrauterine development.

Causes of fetal bradycardia during pregnancy

Fetal bradycardia can occur for many reasons:

1. alcohol abuse;
2. smoking;
3. taking potent medications;
4. toxic environmental effects;
5. anemia;
6. stressful situations;
7. genetic malformations;
8. Rhesus conflict;
9. premature aging of the placenta;
10. toxicosis, oligohydramnios or polyhydramnios.

Normal heart rate

• From 5–6 weeks you can monitor your heartbeat using ultrasound. At this stage, heart rate averages 86 beats/min.
• at 14 weeks the frequency reaches 156 beats, with a daily increase of 2-3 points.
• starting from the 15th and before labor, the norm is considered to be from 140 to 160 beats per minute. A decrease in heart rate to 120 indicates an acute lack of oxygen; the baby has developed hypoxia. Bradycardia in the fetus is recorded at even lower levels.

Types of rhythm reduction

There are two types of low heart rate:

• basal – determined by frequency with parameters up to 110 beats/min. With timely diagnosis and after the start of compensatory therapy, it does not cause any serious complications. It often occurs due to low blood pressure in a woman or during intrauterine compression of the baby’s head.
• the decelerant appearance is caused by heart contractions of up to 90 beats. The baby noticeably lacks oxygen, the child’s life is in danger and immediate treatment is required.

Bradycardia in early pregnancy - treatment

Pathology involves the use of compensatory therapy, as well as additional safety measures:

1. droppers with solutions of carboxylase and sodium bicarbonate;
2. glucose, sodium gluconate and ascorbic acid intravenously;
3. taking iron supplements for anemia;
4. adjusting the diet in favor of healthy foods and avoiding fried, smoked and salty foods;
5. eliminating bad habits.

Constant monitoring of the child’s heart rate is carried out using ultrasound diagnostics, CTG and auscultation.

Detection of a low heart rate in an infant in the later stages suggests the use of a planned caesarean section.

In order to minimize the occurrence of pathology in a child, it is necessary to normalize the daily routine, give up alcohol and engage in moderate physical activity. Walking in the fresh air should become a habit, and taking medications should only be under the strict supervision of a doctor.

During pregnancy, not only the health of the expectant mother, but also the baby in the womb is monitored. For this purpose, regular preventive examinations are carried out to monitor the child’s vital signs. One of the deviations from the normal state is fetal bradycardia during pregnancy. The fetal heartbeat can be determined as early as the fifth week of pregnancy using a vaginal ultrasound and, starting from the seventh, a standard one. At different stages of pregnancy, the heartbeat has its own normal values.

Etiology and manifestations of fetal bradycardia

Fetal bradycardia or a decrease in the child's heart rate can occur at any time during pregnancy. More often, such disorders occur in the later stages of pregnancy. Normal heart rates are as follows:

• 110-130 beats/minute from 6 to 8 weeks;
• 170-190 beats/min from 9 to 10 weeks;
• 140-160 beats/min from 11 weeks until birth.

Due to the development of the autonomic nervous system and the growth of the child, the baby’s heart rate changes greatly. Bradycardia in the fetus occurs for various reasons and indicates one of the conditions:

• violation of the health status of a pregnant woman;
• convulsions and circulatory disorders in a pregnant woman;
• umbilical cord entanglement;
• placental abruption (partial);
• placenta previa or infarction;
• umbilical cord compression;
• prolapse of the umbilical cord;
• ruptures of blood vessels;
• anemia of various origins;
• fetal development abnormalities;
• severe form of toxicosis (long lasting);
• infectious diseases of various etiologies;
• long-term use of drugs that have a toxic effect on the fetus;
• severe chronic pathologies of the mother;
• polyhydramnios or oligohydramnios;
• bad habits (smoking, alcohol);
• pregnancy with two or more fetuses.

To confirm the diagnosis, an ultrasound examination is performed twice with an interval of three or seven days, depending on the indicators of the first examination. The diagnosis is made if the child has a heart rate of less than 110 beats per minute for ten minutes or more.

Types of fetal bradycardia

Bradycardia during pregnancy has two types. Basal bradycardia – accompanied by a heartbeat at around 110 beats/min. This type of pathology, with timely detection and adequate treatment, does not cause complications. Sometimes it is provoked by long-term low blood pressure in a pregnant woman or compression of the baby’s head. Decelerant bradycardia is characterized by a decrease in the child’s heartbeat to 90 beats per minute. In most cases, the cause is considered to be hypoxia (lack of air for the baby in the womb). Indicates that the fetus has problems. Urgent hospital treatment is required.

Find out what a young mother's diet should be like after childbirth.

You can read what to do if you have low blood pressure during pregnancy here.

Sinus bradycardia during pregnancy is considered the most dangerous condition for the unborn child, as the heart rate decreases to 70 per minute. With this state of health of the baby, intensive treatment is carried out, and the pregnant woman is in the hospital, sometimes until childbirth. If treatment is refused, there is a risk of fetal death.

However, in some cases, such a condition is normal for a growing child and is confirmed or refuted after a complete examination of the pregnant woman.

The main types of diagnostics are ultrasound, CTG (cardiotocography) and Doppleroscopy. The number of times and intervals between examinations is determined by the treating gynecologist. More frequent blood and urine tests may also be needed. In addition to the heartbeats, the heart muscle itself is examined.

To carry out a set of therapeutic measures aimed at restoring the normal heartbeat of the fetus, pregnant women are recommended to undergo treatment in a hospital under round-the-clock medical supervision.

Bradycardia in the fetus in later stages may in some cases be an indication for cesarean section. The main goal of treatment is to stabilize the child’s condition and carry the pregnancy to full term.

Treatment is prescribed based on the results of examinations and is adjusted taking into account changes in the child’s condition. If the mother's condition worsens, symptomatic treatment is carried out. All traditional medicines and folk treatments (teas, tinctures) are prescribed only by a doctor. Medicines are selected by the doctor, taking into account the possibility of use during pregnancy and the effect on the fetus (as necessary).

Find out how the height of the uterine fundus should change in a pregnant woman.

You can read about the dangers of retrochorial hematoma during pregnancy here.

You will find out what to do for constipation during pregnancy here: http://moeditya.com/pregnancy/vedenie/zapor-pri-beremennosti.

It is recommended to undergo inpatient treatment and give up bad habits: smoking, alcohol. It is important to correctly distribute the daily routine and the load on the body (doing labor-intensive work, etc.). Dietary nutrition will speed up the healing process.

Timely preventive actions to protect against infectious diseases, strengthening the immune system and reducing stress on the nervous system of the expectant mother will have a beneficial effect on the baby’s condition.

Preventive actions

The causes of fetal bradycardia relate to poor nutrition and bad habits, and therefore, as a preventive measure for this type of pathology, the diet is adjusted in favor of fruits and vegetables, dairy products, and nuts. Quitting bad habits and restoring the immune system play an important role. Being in the fresh air will enrich the blood with oxygen and help the normal functioning of the child’s heart. Light gymnastic exercises, sitting on a chair or on the floor, will maintain muscle tone at the proper level. Timely consultations with the treating gynecologist and examinations will help prevent the development of the disease and reduce the risk of complications.

moeditya.com

Bradycardia in the fetus during pregnancy is common. For example, fetal bradycardia in the early stages (up to 8 weeks) indicates a high risk of subsequent detection of chromosomal abnormalities (Down, Patoau, Edwards syndrome, etc.). If fetal bradycardia appears at 6 weeks, then special monitoring is required for its intrauterine development, since there is a high risk of heart defects, central nervous system disorders and other severe abnormalities.

If bradycardia in the fetus during pregnancy appears after the 8th week, then this most likely indicates that the placental circulation is impaired - the fetus lacks oxygen and nutrition. In this case, the ultrasound doctor notes the duration and causes of fetal bradycardia: whether the decrease in heart rate is constant or only long-term. If the heart rhythm is restored after some time or even exceeds the norm, then, most likely, there is an immaturity of the automatism of the sinus node, and such bradycardia of the heart in children does not pose a threat.

The cause of bradycardia in children may be the possible formation of a congenital heart defect in the fetus. In this case, close monitoring is required.

Causes and types of childhood bradycardia

Electrical impulses arising in the heart force it to contract - this phenomenon is called automaticity. It is provided by atypical muscle fibers that form a system of bundles and nodes in the myocardium - the conduction system. It includes the atrioventricular node, the sinoatrial node and the branch bundles from them that transmit nerve impulses to the myocardium.

Bradycardia is either sinus or appears as a result of blockade of the passage of impulses between the atrium and the sinoatrial node or the atrium and the ventricles.

Sinus bradycardia in a child can be caused by a congenital decrease in the automaticity of the pacemaker - the sinus node. Pathological sinus tachycardia can result from compression of the vagus nerve and birth trauma.

Moderate bradycardia in adolescent children is usually caused by hormonal surges, vegetative-vascular dystonia, rapid growth, and the onset of smoking and drinking alcohol.

But there are also more serious reasons, in particular, myocarditis, which causes shortness of breath and pain in the heart. Here the parents probably take the child to the doctor.

Manifestations of different types of bradycardia in children

The threshold for determining bradycardia in an adult is below 60 heart beats per minute.

Typically, mild bradycardia in children does not cause circulatory problems and has no consequences.

Severe bradycardia in children can be manifested by the following symptoms:

• weakness;
• dizziness;
• fast fatiguability;
• attention disorders;
• blood pressure surges;
• fainting and semi-fainting states.

If such symptoms appear against the background of bradycardia, then the child should be immediately taken to the doctor.

Severe bradycardia, characterized by a strong decrease in heart rate, sometimes manifests itself as Morgagni-Adams-Stokes syndrome, which is characterized by sudden seizures with temporary cardiac arrest and loss of consciousness. MAS syndrome occurs when the signal between the ventricles and atria is blocked. Be alert for the following symptoms:

• The child suddenly becomes dizzy.
• Dark circles before the eyes.
• The child turns pale and loses consciousness after a few seconds.
• Later, convulsions begin, sometimes accompanied by involuntary urination, cessation of breathing and cardiac function.
• After the heart resumes functioning, the child quickly returns to consciousness, but only occasionally remembers what happened to him.

Treatment of bradycardia in children

Bradycardia in children requires treatment only in case of circulatory disorders associated with it - dizziness, attacks of weakness, etc. First of all, the underlying diseases that caused bradycardia, such as heart defects or myocarditis, are treated. In addition, medications that accelerate the heart rate (caffeine, belladonna, and others) are prescribed.

To identify the causes of childhood bradycardia, an examination is necessary. Only the attending physician, based on the results, will prescribe adequate treatment.

If you have had to deal with childhood bradycardia, write in the comments how this disease was identified and how it was treated. In this way you will help many children and their mothers!

beregi-serdce.com

Types of disease

Starting from 8 weeks of pregnancy, regular visits to the doctor make it possible to determine at an early stage a decrease in the heart rate of the fetus in the womb. This is important because it allows you to recognize any deviation and say with confidence what type it is and how serious it is.

There are 2 types of bradycardia in the fetus:

Causes of the disease

Fetal bradycardia can develop due to the following reasons:

Among the reasons contributing to the development of bradycardia in a child, there are both serious and minor factors, the effects of which can be easily prevented. But in any case, the disease sometimes entails dire consequences. Thus, prolonged hypoxia resulting from lack of treatment threatens the life of the fetus.

Important! Delay in treatment often leads to irreversible and terrible consequences - the development of anomalies that affect the health of the embryo, and even its death.

In newborns, bradycardia is sometimes a sign of congenital disorders in the development of organs (including heart defects), hypoxia experienced in the womb, birth trauma, and metabolic disorders. There are a number of other reasons, so in each case it is set individually.

Symptoms

Naturally, it is very difficult to notice the development of this disease during pregnancy, but in a newborn its manifestation can be noticed due to pronounced signs. By the way, it often appears before an attack of sudden respiratory arrest. When walking, especially on cool days, your heart rate slows down as you exhale.

Sinus bradycardia is considered serious, since when it occurs, the heart rate can drop to 70 beats per minute. Sometimes this may even indicate a serious malfunction of the heart (for example, congenital blockade). The symptoms are as follows:

Important! If a low heart rate (less than 100 beats) is detected in a newborn, you should not wait for other signs indicating illness to appear. You should immediately visit a doctor and strictly follow the recommendations he gives.

Every doctor will say with confidence that the best treatment for fetal bradycardia is to follow all recommendations. Prevention will significantly reduce the possible risk of injury, but we must not forget that visits to the hospital are necessary not just for record keeping, but also in order to prevent such deviations.

Treatment of bradycardia that occurs in the fetus depends on the causes, causing the disease. In the mildest cases, it will be enough to adjust your diet and daily routine, and normalize the supply of missing vitamins by taking mineral complexes. Walking is definitely recommended, as moderate physical activity and oxygen saturation prevent hypoxia and restore strength. Drugs are prescribed by a doctor if necessary to compensate for chronic or infectious diseases, as well as for iron deficiency and anemia.

Subsequently, the baby in the womb is monitored regularly. The most comprehensive diagnostic tools are used - from simply listening to the mother’s abdomen with a stethoscope to cardiotocography and ultrasound. Using the same means, fetal bradycardia is detected.

Important! During pregnancy, studies are carried out a certain number of times. Do not be afraid that any radiation will negatively affect the baby - this is not the case. Remember that your refusal to undergo diagnostics jeopardizes the health of the unborn baby and even his life.

Bradycardia detected at an advanced stage of pregnancy can sometimes cause very serious pathologies to the fetus, and therefore, in some cases, a very radical, but often inevitable solution to the problem is possible - preventing negative effects through cesarean section. Such decisions are made if the child is viable and can survive after birth.

Medicines are introduced into the mother’s body, entering the womb through the bloodstream, which also affects its improvement. When selecting medications, the type of bradycardia in the fetus, the reason for its development, the duration of pregnancy and the general condition of the woman are always taken into account. The drugs are administered in the following order:

Note! The medications described above are most often used to treat the disease, but other medications may be prescribed in your case. It all depends on the characteristics of the disease.

Monitoring of the course of the disease is always carried out during childbirth, if such a pathology was present during pregnancy. This means that with a sharp drop in heart rate and, as a consequence, the occurrence of an acute course of the disease, atropine is administered to both the newborn and the mother.

Timely contact with specialists and strict adherence to the intended treatment regimen must also be accompanied by maintaining a healthy lifestyle. Remember that any negative habit can cause suffering for the child in the womb and, most importantly, often entails serious consequences. They can appear even after the baby is born, so be attentive to your health throughout the entire period of pregnancy.

iserdce.ru

Types of fetal bradycardia

Due to basal bradycardia, heart rate decreases to 110 per minute. This disease is usually caused by hypotension in the mother. With proper and timely treatment, basal bradycardia of the heart does not pose any danger, including during future births.

With decelerant bradycardia, the heart rate decreases to 90 per minute. As a rule, this is a consequence of hypoxia, i.e. lack of air in the mother's womb. In this case, doctors are concerned not only about the bradycardia of the embryo as such, but also about the lack of air in the mother’s womb, an indicator of which is this disease.

Causes of fetal bradycardia

The causes of bradycardia in the human fetus during pregnancy can be:

• antisocial lifestyle (alcohol, nicotine, drugs);
• low content of vitamins and vitamin-forming substances in food, frequent consumption of fast food;
• lack of fresh air, too infrequent walks of the expectant mother;
• pulmonary and cardiac diseases of women, especially with exacerbation of their chronic course;
• various types of anemia;
• cases of pressure during pregnancy;
• infection;
• toxic drugs affecting the embryo;
• severe state of stress;
• severe forms of long-term toxicosis;
• a number of anomalies of embryonic development;
• prematurely separated placenta;
• cases of umbilical cord entanglement;
• high and low water levels.

Since it is possible to detect bradycardia no earlier than after 20 weeks of pregnancy (i.e. in its fifth month), in order to prevent bradycardia in the embryo, it is necessary to eat properly, lead a healthy lifestyle and follow the general recommendations of doctors for the period of gestation. Regular visits to the doctor starting from 8 weeks of pregnancy (or even better - in the sixth or seventh week) will allow you to determine what diseases of the fetus are possible during the gestation period, in order to subsequently diagnose them in time.

Diagnosis of fetal bradycardia

If it is quite easy to establish bradycardia in a newborn, then in a human embryo the diagnosis of this disease is much more difficult. Modern cardiotocography makes it possible to record embryonic heartbeats, starting from the time of the appearance of this organ. However, bradycardia can be diagnosed only at 20-22 weeks of pregnancy. At earlier stages, diagnosing this disease does not make sense, since the fetal heart rate is constantly changing. The beating of the heart can only determine whether the fetus is alive or dead. This means that at 5, 6, and even 7-8 weeks, the expectant mother should not worry about problems with the fetal heart rhythm. It is advisable to monitor this indicator of the condition of the unborn child only starting from the 20th week.

Further regular monitoring of the child's condition in utero is carried out using complex methods - from simple use of a stethoscope to ultrasound. None of them in any quantities affects the health of the fetus or its subsequent development.

Prevention and treatment of fetal bradycardia

The best preventive measures to prevent fetal bradycardia are a healthy lifestyle with complete abstinence from nicotine and alcohol during pregnancy. Frequent walks of the mother in the fresh air, small, strictly dosed physical activity in the early stages of fetal development, etc. also help prevent bradycardia. It is also recommended to avoid certain medications that cause specific side effects, such as articaine.

If doctors do make a diagnosis that involves treating fetal bradycardia, this is usually due to causes such as anemia or infectious diseases. In the first case, iron-containing drugs are prescribed, in the second - antibiotic drugs.

Sometimes, if symptoms of fetal bradycardia are recorded in the later stages of its development, the threat of giving birth to a child with serious pathologies is obvious. In such cases, a caesarean section may be used.

The fetal heart rate is monitored throughout pregnancy to monitor the dynamics of its development and favorable condition. The phenomenon of slowing down the rhythm can be diagnosed in the early and late stages of pregnancy.

Bradycardia in the fetus during pregnancy often accompanies pathologies of blood vessels, heart and other organs.

Heart rate detection

In the first and second trimester, doctors use different methods to assess the functioning of the organ:

• transvaginal examination is carried out early, up to 6 weeks;
• at 6-7 weeks, ultrasound is used;
• at 22 weeks the heart is fully formed, you can listen to it with a stethoscope;
• At 32-34 weeks of pregnancy, a cardiotocogram (CTG) is performed. The technique is reminiscent of taking an electrocardiogram and allows you to determine the contractility, excitability and conductivity of the fetal myocardium.

Additionally, from 30 to 34 weeks, a Doppler examination of the vessels of the uterus and baby may be prescribed to determine the speed of blood flow through the umbilical arteries. Along with instrumental diagnostics, urine and blood are collected from the mother.

Fetal heart rate is measured throughout pregnancy. The fetal heart develops from the 2nd week and beats from the 3rd. After the organ chambers have formed, it can be listened to (at 6-8 weeks). The number of strokes constantly changes as the veins, aorta, and blood vessels develop.

Norms at different stages of pregnancy

The normal embryonic heart rate is 110-170 beats/min. Indicators differ at different periods of gestation depending on its development. The number of measurements taken increases if it is slow. An excess is called tachycardia, a rare heartbeat in the fetus is called bradycardia.

Did you know! At the beginning of bearing a child, the rhythm rate is relative. Doctors are faced with the task of making sure that there is no frozen pregnancy.

The numerical indicator may fluctuate within the normal range depending on the size of the embryo at the same period in different women. For example, if its length is within 5 mm, then the optimal value is 100 beats/min. With large sizes, the heart rate is 120-130 beats.

In the last trimester, to diagnose pathology or the level of fetal development, it is possible to determine the position of the myocardium and the characteristics of the pulse (weak or rhythmic heartbeat).

Heartbeat correspondence table by week:

As can be seen from the data presented, in the first trimester there is an increase in numerical indicators. After the formation of the nervous system, on the contrary, the numbers decrease.

Interesting fact! The value of the parameters is influenced by the physiological characteristics of the woman in labor, her emotional state, and the genetic factor.

The main indicator of the norm is the lower limit – 85, the upper – 200 beats/min.

Deviations from the norm

Poor heartbeat at the beginning of the term when the embryo is up to 8 mm in length may be a consequence of a missed abortion.

Listening to fetal tachycardia is sometimes a consequence of a lack of oxygen in the womb. This condition is the result of a long stay in a closed, unventilated room. A pregnant woman is prescribed a blood test for hemoglobin to rule out iron deficiency anemia.

Sometimes palpitations occur after active physical activity of the expectant mother and go away on their own.

Among the causes of bradycardia are:

• fetal hypoxia;
• fetoplacental insufficiency;
• breech presentation;
• high or low water levels.

Treatment tactics are determined after additional examination and elimination of unfavorable factors. Sometimes the slowing of the rhythm is due to a hereditary factor and does not pose a danger to the baby’s cardiovascular system.

Slow fetal heart rate

The diagnosis is established when the readings are below 110 beats/sec. for more than 10 minutes. Bradycardia in the first trimester is a consequence of previous rubella and other infectious diseases, radiation, and poor ecology in the area of ​​residence.

Causes of decreased heart rate include:

• fetal hypoxia, accompanied by increased potassium levels and acidosis;
• cardiac abnormalities;
• umbilical cord entanglement;
• Rhesus conflict;
• developmental delay;
• previous placental abruption;
• prolonged lack of oxygen in tissues;
• incorrect location in the womb;
• influence of taking medications (beta-blockers).

Until the 8th week, a decrease in the frequency of organ contractions can be caused by chromosomal abnormalities (Down syndrome, Edwards syndrome) and developmental defects. For diagnosis, a “double test”, chorionic villus biopsy, and amniocentesis are used.

Sometimes bradycardia is a variant of the norm: it occurs after childbirth and is accompanied by sufficient oxygen saturation.

Types of pathology:

• low basal heart rate;
• prolonged decrease in rhythm frequency with repeated episodes;
• true bradycardia.

The least harmless is basal bradycardia. It is recorded when the heart rate decreases to 110 beats/min. When prescribing compensatory therapy, the changes are reversible. The reasons for this condition are hypotension of the pregnant woman, compression of the child’s head. Basal bradycardia with a heart rate of 80 beats per minute may accompany complete organ block.

Deceleration is established when the heart rate is determined to be 110-120 beats.min. within 60 seconds. A type of pathology is sinus bradycardia. The number of recorded beats is 70 beats/min. Treatment is carried out in a hospital, the patient is prescribed complete rest until delivery. The risk of miscarriage is quite high.

Among the causes of true bradycardia are:

• maternal hypothermia;
• hypotension;
• hypoglycemia;
• umbilical cord compression;
• CMV infection.

A prolonged decrease in heart rate at the end of delivery is not classified as a pathological abnormality if:

• pregnant woman is not at risk;
• rhythm disturbances did not occur in the first and second periods;
• rhythm variability was preserved.

It is important! Indirectly, bradycardia can be indicated by any disturbance in fetal movements (increased or slowed down). It is imperative to inform your doctor about this.

Danger of rhythm disturbances

Why is slowing the heart rate dangerous? Long-term bradycardia causes severe developmental pathologies. Due to lack of oxygen saturation, fetal death inside the womb may occur as a result of hypoxia. Treatment consists of administering medications to the mother's body. Through the general circulatory system, medicinal substances reach the child and normalize his condition.

If therapy fails in late pregnancy, an emergency caesarean section is indicated.

Must remember! The most dangerous is sinus bradycardia (less than 70 beats per minute). The condition of the embryo becomes critical and requires immediate medical attention.

Treatment of pathology

If there are consistently small deviations from the norm, the pregnant woman is constantly monitored for the dynamics of the condition. A course of vitamins may be prescribed to normalize cardiac parameters.

If episodes of low heart rate recur, hospital treatment is recommended. To prevent the development of pathology, the expectant mother needs lifestyle correction:

1. Avoid nicotine and alcohol consumption. Replace tonic strong drinks with juices and green tea.
2. Follow your rest schedule and spend more time outdoors.
3. A pregnant woman's diet should be complete and balanced, rich in minerals and vitamins.

Even at the stage of pregnancy planning, it is necessary to get rid of chronic foci of infection, lead an active lifestyle, not exhaust the nervous system, and undergo regular preventive examinations.

It is necessary to treat bradycardia in the fetus during pregnancy in a timely manner, at the initial stage of its appearance. A competent medical approach will reduce its manifestations and prevent the development of other dangerous complications.

Pregnancy is a rather difficult and responsible period in the life of every woman. She should be attentive to her health, since the expectant mother is responsible not only for herself, but also for the child. It is very important during this period to promptly detect the development of diseases and disorders. This helps prevent serious consequences, one of which is fetal bradycardia.

Classification

Heart muscle cells begin to form in the third week of gestation, and the first beats can be heard during an ultrasound in the fifth week. Before this period, any listening to the heart rhythm is not informative. The procedure is performed only from 11 to 13 weeks to confirm pregnancy.

Bradycardia in the fetus is characterized by an abnormal heart rate. Depending on the period of gestation, certain standards for the number of contractions of the fetal heart muscle have been identified.

Important! In the eighth week, a woman should visit a doctor regularly. Examinations and observation by a specialist can detect fetal bradycardia in the early stages of pregnancy. Timely diagnosis allows you to identify the type of disorder.

Diseases in medicine are divided into the following types:

1. Basal. It is characterized by a decrease in the number of contractions of the heart muscle, it does not exceed 110 beats per minute. Its pathology poses a danger to the body of the mother and baby, and also does not cause the development of serious consequences. With timely diagnosis, basal bradycardia can be completely cured.
2. Decelerant. Heart rate decreases to 90 beats per minute. The cause of development is hypoxia, when the fetus does not have enough air. This provokes irreversible changes and requires immediate treatment.
3. Also isolated. It is a type of decelerant type and manifests itself in the form of a decrease in heart rate to 70 beats per minute. The danger of the disease is that in case of untimely assistance from specialists, the fetus may die. The risk of miscarriage increases. That is why, when this type is established, the woman is sent to a hospital, where treatment is carried out under the supervision of doctors, most often before childbirth.

Causes

A number of factors can provoke the appearance of bradycardia in a child. A common cause of this condition is the young mother’s unhealthy lifestyle: the woman drinks alcohol or drugs, smokes. The development of bradycardia in the fetus is also provoked by:

1. Insufficient amount of vitamin substances in food.
2. Rare walks in the fresh air, as a result of which the child experiences a lack of air.
3. Cardiovascular diseases or pulmonary pathologies diagnosed in a woman.
4. Anemia.
5. Infectious diseases.
6. Stress or nervousness.
7. Exposure to toxic substances that negatively affect the condition of the baby in the womb.
8. Toxicosis, which lasts for quite a long time in a severe form.
9. Low water.
10. Entwining the fetus with the umbilical cord.
11. Placental abruption that occurs prematurely.
12. Deviations in the development of the embryo.
13. Polyhydramnios.

It is possible to detect bradycardia only at 20 weeks of pregnancy. There are enough reasons for the development of the disease. Uterine fibroids previously diagnosed in a woman can also have an impact and increase the risk of a disorder. That is why doctors recommend that women monitor their health and visit a doctor regularly.

Symptoms

It is quite difficult to establish the presence of the disease, since the woman does not show symptoms. Often, the expectant mother feels well, and a slight deterioration in her health is attributed to fatigue or stress.

Signs of the disease are clearly manifested in a newborn child. Most often, the pathology is characterized by a sudden stop in breathing. You can also slow down your heart rate while walking.

It can be detected through ultrasound examination by the following signs:

1. Deterioration of the heart muscle.
2. Slowing down of fetal movement and stopping of movement may occur.
3. Rare breathing or periodic stopping.
4. Presence of convulsive seizures.
5. Stopping the heartbeat or critically reducing the number of heartbeats.

Sinus bradycardia is considered the most dangerous heart rate disorder. The number of beats can be reduced to 70. In certain cases, this may indicate the presence of serious disturbances in the performance of the heart muscle. In this case, the following signs are observed:

1. Freezing of movements.
2. Cramps.
3. Paleness of the skin or cyanosis.
4. Heart failure.

This condition requires immediate assistance from specialists, as the risk of frozen pregnancy and fetal death increases significantly.

Treatment

In cases of persistent bradycardia after the thirtieth week, the specialist may decide to perform a premature birth by cesarean section. This helps reduce the risk of complications.

But in certain cases, the disease is not dangerous for the woman and child. Therapy in such cases is aimed at eliminating factors that influence its development. Drug treatment is used, which includes taking the following drugs:

1. "Papaverine". Helps reduce uterine tone and fetal hypoxia.
2. . Iron supplements and ascorbic acid are used.
3. Glucose.
4. Magnesia.

1. Observe the work and rest schedule.
2. Reduce physical activity.
3. Take regular walks in the fresh air.
4. Follow a diet.
5. Support immunity.

If you follow all the rules, your heart rate can improve. But medical supervision is carried out not only during pregnancy, but also after childbirth.

Bradycardia may not always be a threat to the health of mother and baby. With timely treatment, the disorder does not cause complications.

Prevention measures

Bradycardia in the fetus is established in the later stages, after the 20th week. To prevent the development of the disorder, the expectant mother needs to take her health seriously and follow the following preventive measures:

1. Stop drinking alcohol and smoking.
2. Eat properly. The diet should include not only fresh fruits and vegetables, but also nuts and dairy products.
3. Get outdoors regularly.
4. Maintain a work and rest schedule.

Adequate sleep is also of particular importance. A healthy person should sleep at least 8 hours. But the female body experiences serious stress during pregnancy. This is why the expectant mother should get enough sleep.

When visiting a doctor and undergoing diagnostic tests, mothers who have been diagnosed with the disease are interested in what fetal bradycardia is and what danger it poses to the baby. The prognosis depends on the degree of development, the woman’s health status, the type of disorder and the effectiveness of therapy. In some cases, bradycardia does not pose a threat to the fetus. That is why the disease requires careful monitoring by specialists.

In which the human heart rate abnormally slows down. This condition is dangerous for pregnant women and the fetus they are carrying, because the saturation of the brain with oxygen depends on the heart rate.

For those planning to have children, it is useful to learn about the types, causes and diagnosis of bradycardia during pregnancy.

Safe bradycardia that does not affect the health of the woman and fetus is called physiological. It is typical for those who live actively and play sports. Additionally, your heart rate naturally slows down in cold weather and during sleep.

In a pregnant woman

A decrease in heart rate to 60 beats per minute or lower, which threatens the health of the pregnant woman and the unborn baby, is called pathological bradycardia. This condition requires. It develops with unstable blood pressure. The following cardiac ailments may also occur:

• myocardial dystrophy.

The pulse of the expectant mother may slow down due to a disturbance in the composition of the blood. Bradycardia in pregnant women is caused by gastrointestinal pathologies, various injuries, as well as the following diseases:

• hypothyroidism;
• tumors;
• infections;
• poisoning;
• renal failure.

In the fetus

Some medications cause a slowdown in the fetal heart rate. Rhesus conflict also leads to bradycardia - incompatibility of the blood of a woman and the fetus according to the Rh factor. In addition, heart rhythm disturbances in the fetus occur for the following reasons:

• due to a toxic environment;
• maternal anemia;
• mental stress in a pregnant woman;
• developmental defects;
• early aging of the placenta;
• failure in the accumulation of amniotic fluid.

A decrease in the fetal heart rate can occur if a pregnant woman smokes or drinks.

Pregnancy in patients with bradycardia

The condition of patients with an already diagnosed disease may worsen after they become pregnant. In addition, a decrease in a woman's heart rate will affect the fetus. A slow pulse in a potential mother leads to chronic hypoxia of the embryo, in which developing tissues lack oxygen. At the same time, the unborn child lags behind in development, his brain is formed incorrectly, which in the worst cases threatens with mental retardation.

To avoid undesirable consequences for themselves and the baby, women with bradycardia need to plan their pregnancy taking into account the recommendations of a cardiologist. During pregnancy, patients should be observed by this specialist.

Fetal pulse is normal and abnormal

The embryo's heart begins to beat on the 21st day of development. At 3-5 weeks it contracts 75-85 times per minute. Over time, the pulse quickens, and after the formation of the nervous system it gradually decreases. Normally, the indicators change as follows:

1. At 5-6 weeks, the heart contracts 80-100 times every minute.
2. At 6-7 weeks, the pulse is close to 100-120 beats per minute.
3. At weeks 7-9, the heart rate reaches a peak of 140-190 beats every minute.
4. At 10-12 weeks, the heart rate drops to 160-180 beats per minute.
5. After 3 months of pregnancy, the fetal pulse does not exceed 140-160 beats every minute.
6. By the 9th month, the heart beats 130-140 times per minute.

Fetal pathology is diagnosed if in the 2nd trimester the pulse is less than 110-120 beats per minute.

Fetal bradycardia in early and late stages

If at 6-8 weeks of development and later the embryo’s pulse does not exceed 85 beats per minute, it is not bradycardia of the fetal heart that is suspected, but rather arrest or developmental defects. In other cases, a decrease in fetal heart rate that occurs in the early stages is not considered a pathology.

Bradycardia is diagnosed only after 20 weeks of gestation, if the unborn baby’s heart beats less than 120 times per minute.

Types of embryonic disease

There are 3 types of fetal bradycardia: basal, decelerant and sinus. Typically, these conditions develop due to fetal hypoxia, which occurs for the following reasons:

• due to compression of the head;
• due to maternal anemia;
• due to low blood pressure in the mother.

Basal bradycardia is diagnosed if the fetal heart beats less than 120 times per minute. If you treat the malfunction in time and eliminate its cause, you will be able to avoid harm to the woman and the fetus.

If the decelerant nature is violated, the heart rate of the embryo does not exceed 72 beats per minute. This condition requires hospital treatment with bed rest.

With the sinus form of the disease, the fetal pulse drops to 70-90 beats per minute. In this case, the woman needs urgent hospitalization with intensive care and observation until childbirth, because a failure threatens the fading of the pregnancy.

We talked about the reasons for the appearance of different ages, as well as whether it is dangerous and what to do in this case, in a separate article on our website.

How to detect a slow heart?

Bradycardia of the mother and fetus manifests itself through symptoms of oxygen starvation. Wherein A pregnant woman experiences the following ailments:

• with weakness;
• with dizziness;
• with headache;
• with noise in the ears;
• with shortness of breath;
• with low blood pressure;
• with chest pain.

Cognitive failures, expressed in memory and attention impairments, are possible. A slow pulse is also indicated by a pre-fainting state.

An anomaly that exclusively affects the fetus does not affect maternal well-being. It can only be detected using modern diagnostic methods.

What will auscultation show?

After 18-20 weeks, each examination by an obstetrician-gynecologist includes auscultation - listening to the embryo's heart using a special stethoscope, a hollow tube made of wood or metal. To hear the heartbeat of the unborn child, the doctor proceeds as follows:

1. Places one end of the stethoscope on the pregnant woman’s belly and puts her ear to the other end of the device.
2. Finds the point at which the fetal heartbeat is clearly audible.
3. It records the minute during which it counts fetal heartbeats.

The disadvantage of auscultation is its inaccuracy: Diagnosis may be compromised by many factors, including maternal obesity and increased fetal movement during examination.

Ultrasound of the heart

Instrumental methods, such as ultrasound diagnostics, allow for more accurate research. In this case, a special sensor is used, which is applied to the pregnant woman’s abdomen or inserted transvaginally. It transmits data to the screen, which is decrypted by a specialist.

The following disorders indicate a slow pulse:

• slow movements of the embryo;
• convulsions;
• stopping the movement of the embryo.

Rare breathing or heartbeat, as well as their periodic stopping, also indicate bradycardia. Ultrasound can be performed as early as 3-5 weeks of pregnancy.

CTG and other diagnostic methods

Cardiotocography is used for diagnosis from 32 weeks of pregnancy. The essence of CTG is recording and comparing the pulse of the unborn child with the frequency of uterine contractions. The results of the study are deciphered as follows:

• 8-10 points - the condition of the fetus is normal;
• 6-7 points - mild bradycardia occurs;
• 6 points or less - the fetus is in serious condition.

Another effective way to identify the disease is phonoelectrocardiography, in which the electrical impulses of the heart are recorded and analyzed. This method is a combination of ECG with phonocardiography - listening to heart murmurs.

When is an ECG used?

An electrocardiogram is resorted to if the pregnancy is proceeding with disturbances or there is a threat of any anomalies. From the embryo side, the following indications are distinguished:

• developmental delay;
• previously diagnosed cardiac pathologies;
• suspicion of developmental pathologies.

Conducted for pregnant women who are over 38 years old or have previously given birth to children with developmental defects. Also from the mother’s side there are the following indications:

• hypothyroidism;
• hyperthyroidism;
• diabetes;
• cardiovascular diseases;
• severe infections.

Bradycardia is indicated by the appearance of a P wave on the cardiogram, as well as a significant T-P and P-Q interval. The most accurate data is obtained by performing an ECG at 18-24 weeks of pregnancy.

Having discovered an arrhythmia in the unborn baby, its causes are found out. Based on them, a prognosis and treatment strategy for the disease are drawn up. They try to compensate for the mother’s chronic illnesses, and in case of problems with the placenta, drugs are prescribed to stimulate uteroplacental blood flow.

Severe conditions are treated inpatiently, in which natural childbirth is impossible and a caesarean section is indicated.

At-risk groups

Those who suffer from chronic diseases are prone to bradycardia. The risk group also includes women living in conditions of physical or psychological discomfort.

To reduce the likelihood of complications when carrying a child, you need to monitor the course of the underlying disease, give up bad habits and turn to physical therapy. Wherein Regular visits to an obstetrician-gynecologist and other specialized specialists are required.

Bradycardia can lead to pregnancy loss or death of the woman. To prevent this from happening, expectant mothers should be careful about their own health. A timely visit to the doctor and correct diagnosis will allow you to identify the problem before it causes irreparable harm.