When the ultrasound becomes audible as the fetal heart beats

Weekly fetal heart rate is an important parameter during pregnancy, which is subject to constant monitoring. The palpitation begins in the fifth week of embryonic development and manifests itself throughout pregnancy and childbirth. This parameter deserves attention, because the heart rate (HR), which is different for a certain period, can tell about possible disorders in the work of the heart, hypoxia, anemia, defects. The absence of a heartbeat may indicate the onset of a miscarriage or a "frozen" pregnancy. In some situations, a deviation noticed in time can save the life of the fetus.

Why is the diagnosis of heart rate and the norm of this parameter in the fetus needed?

The heart is one of the first organs to develop in the embryo. Everyone knows its value in the body. The importance of the parameters of its activity during intrauterine development is also important.

1. The fact that there is a heartbeat indicates that the fetus is alive. In early pregnancy, heart contractions may not be detected immediately, so it is better to re-examine after a week or two. If the heartbeat is not detected during the secondary diagnosis, this indicates the death of the fetus.
2. During pregnancy, the heart rate is checked for compliance with the term.
3. Identification of pathological conditions.
4. During childbirth, monitoring heart rate helps to identify hypoxia in the child and take timely measures.

When does a fetal heartbeat appear? The formation of the heart occurs in the first four weeks. In the second and third weeks, it looks like a tube. In the second half of the first month, the organ begins to bend in the shape of the letter S. In the fifth week, separate cardiac cavities form (at first three instead of four), and the heart begins to contract. This heartbeat cannot be fixed with a conventional stethoscope, and it is not advisable to do an ultrasound examination, since such frequent interference harms the baby's body. Ultrasound at such an early stage is prescribed only according to indications, for example, if you suspect a “frozen” pregnancy.

An indicator of the normal development of the embryo during this period is the level of human chorionic gonadotropin (hCG). This control method can be used up to the tenth week of pregnancy. Normally, the level of hCG in the fifth or sixth week is 1000-3100 mIU / ml. And this value is growing very rapidly, doubling every three days. In the third month of pregnancy, the hCG level no longer makes sense in assessing the condition of the child.

Fetal heart monitoring is the most important diagnostic tool during pregnancy and childbirth. It gives a complete picture of the state of health of the mother and child, helps to identify problems in a timely manner and begin treatment.

Changes in heart rate occur depending on the duration of pregnancy. There is a myth that this parameter can determine the sex of the child, in fact, the heart rate is the same for boys and girls.

The norms of the fetal heartbeat can be characterized qualitatively and quantitatively.

In the first case, the assessment is made according to the following parameters:

1. Regularity. Contractions occur at roughly equal intervals of time.
2. Rhythm. The heart rate should change within acceptable limits.
3. heart rate. There are certain quantitative boundaries of this value, the deviation from which indicates some kind of malfunction in the baby's cardiac activity.
4. Heartbeats should be crisp and clear. The opposite suggests that the child suffers from hypoxia in acute or chronic form.

The second trimester is dangerous for the occurrence of arrhythmias. This condition can develop due to hypoxia or heart defects.

The doctor gives an assessment of the development of the embryo, then the fetus, on the basis of a table that indicates the rate of heart rate for each week of pregnancy. The change in the value of heart rate actively occurs in the first trimester of intrauterine development, in the second and third trimesters the parameter almost does not change.

• in the fifth week, the heart rate is 80-105 bpm;
• on the sixth - 106-120 bpm;
• on the seventh - 127-149 bpm;
• on the eighth - 150-172 bpm;
• on the ninth - 155-195 bpm;
• on the tenth - 161-179 bpm;
• on the eleventh - 153-177 bpm;
• on the twelfth - 150-174 bpm;
• on the thirteenth - 147-171 bpm;
• on the fourteenth - 146-168 bpm;
• starting from the fifteenth and until the end of pregnancy - 140-160 beats / min.

Methods for diagnosing a heartbeat

The doctor controls the fetal heartbeat in the following ways at different stages of pregnancy:

• auscultation;
• ultrasound;
• cardiotocography;
• echocardiography;
• diagnosis with a heartbeat detector.

Auscultation is listening to the heartbeat with a stethoscope. The device is attached at one end to the woman's stomach, and the other end is attached to the doctor's ear.

1. You need to find a listening point. To do this, the doctor determines the position of the child in the mother's abdomen with the help of palpation.
2. It is important to correctly assess the frequency, rhythm and clarity of heart beats.
3. The doctor must clearly differentiate the heartbeat of the mother and child, so as not to confuse them.

The main advantages of the method are simplicity, accessibility and safety for both the baby and the mother. The disadvantages include the possibility of using the method only in the second half of pregnancy and the influence of the human factor.

Ultrasound is the most popular and reliable method for examining the heart of an unborn baby. At what time is the fetal heartbeat heard on ultrasound? This method can be used from the moment the heart beats in the embryo, that is, at the fifth week of pregnancy. However, a transvaginal transducer must be used for up to six weeks. At the seventh week of pregnancy, a transabdominal probe may be used. At such early dates, the doctor determines the presence and frequency of contractions. The absence of a heartbeat indicates the death of the embryo. An ultrasound examination is rarely performed in the first trimester of pregnancy.

Usually, a planned ultrasound is performed starting from the twelfth week. At this time, the doctor can already identify the location of the heart, its structure, the work of all elements, and, if present, malformations. This method is accurate and fast, but it is often not recommended. Usually, during the normal course of pregnancy, ultrasound is performed three times (at 10-12 weeks, 21-22 weeks, 31-32 weeks).

Cardiotocography (CTG) is a long-term procedure for monitoring the heart rate of the fetus in a state of movement, rest, sleep. CTG is performed in the supine position for 40-60 minutes, and if necessary, longer. An ultrasonic sensor is attached to the stomach in the place where the child's heart is located with the help of soft elastic bands.

It connects to the monitor, in which the signal from the sensor is converted into heart rate. At the same time, another sensor is applied to the belly of the pregnant woman, which registers the moments of uterine tone. A woman is given a remote control with a button in her hand, which must be pressed when the fetus moves. The importance of this point is that the doctor, based on the results, will be able to distinguish possible pathologies at rest and during motor activity.

• the presence of rhythm jumps, normally they should be present;
• blood flow rate;
• the presence of violations: accelerations (tachycardia), decelerations (bradycardia) and sinusoidal rhythm.

This method is used from the 30th week of pregnancy and is carried out repeatedly.

• preeclampsia;
• scar on the uterus;
• rapid aging of the placenta;
• some diseases;
• a small or excessive amount of water in the amniotic space;
• infections;
• pregnancy more than 40 weeks;
• retardation in fetal development.

Echocardiography is not indicated for all pregnant women. The method is indicated only if pathological changes in the heart are suspected. Echocardiography can be used from the 18th to the 28th week of pregnancy. Also, this method is indicated for pregnant women after 38 years.

A fetal doppler is a very handy device that allows you to determine the heart rate of a child. It can be used starting from the third month of pregnancy, up to 6 times during the entire pregnancy. The detector is used both by doctors in hospitals and at home. The duration of the examination is approximately 10 minutes.

Despite the existence of portable devices for recording the heart rate of a child, which allow diagnosing heart rate at home, it is very important to undergo all routine examinations in a clinic under the supervision of a doctor. Only a specialist can objectively assess the health of the fetus.

Reviews of expectant mothers about this device are positive. In emergency cases, when you need to assess the condition of the fetus immediately, but there is no way to quickly get to the doctor, it saves a lot. After all, the state of panic can also have a negative impact on the fetus. Pregnant women say that when they hear the baby’s heartbeat in the headphones, they calm down and all unpleasant symptoms go away. Even if the device showed that everything is fine, you need to visit a doctor in the near future.

There are no other ways to independently determine the heartbeat. If there is a stethoscope at home, then you can resort to the help of relatives. In the later stages, you can hear the baby's heartbeat by putting your ear to the pregnant woman's stomach. But these methods can only determine the presence or absence of a heartbeat. Only a doctor can assess the health of the fetus.

Causes of fetal heart failure

If the diagnosis reveals abnormalities in the work of the child's heart, then this should be an alarm bell for the mother and the doctor. It is necessary to find out the causes of the violation and eliminate them. Heart rate can be either more or less than normal.

1. Insufficient blood supply in the uteroplacental space.
2. Low hemoglobin in pregnancy.
3. Decreased hemoglobin in the fetus. This condition can cause hemolytic disease.
4. Fetoplacental insufficiency.
5. Bleeding in a pregnant woman, caused, for example, by placental abruption.
6. Congenital heart defects in the fetus.
7. Some medicines. Among them are Atropine and often prescribed during pregnancy Ginipral.
8. Mother has a fever.
9. Pathological development of the umbilical cord.
10. Acute fetal hypoxia.
11. Increased intracranial pressure in a child.
12. Prolapse of the umbilical cord.

Bradycardia is rare, but it is more dangerous than tachycardia.

Slow heart rate can be caused by the following factors:

• serious pathologies in the fetus;
• hypoxia in a child;
• impaired metabolism of the mother and fetus;
• heart defects in a baby;
• high levels of potassium in the blood of the fetus;
• mother taking beta-blockers in large quantities.

The above are the pathologies that require an immediate response from the doctor in order to make a decision on their elimination or alleviation of the condition. Treatment is prescribed depending on the severity of the condition and the duration of pregnancy.

Sometimes, if the pathology is severe and the time permits, the doctor decides to artificially induce contractions.

But there are episodic increases or decreases in pressure. They are not associated with any disease. For example, short-term bradycardia can be caused by a long stay of a pregnant woman in a prone position, when the pelvic vessels are squeezed under the weight of the fetus.