Why does bradycardia occur in the fetus in the early and late stages. Bradycardia of the heart in children and the fetus during pregnancy: where does it come from and how does it manifest itself

Expectant mothers are always very worried about the health of their baby in the womb. Unfortunately, the healthiest pregnancy can end in sad consequences. In five percent of cases, the child is not born, although initially there were no pathologies in its development.

Heart problems at the stage of development of the child can turn into fatal consequences if they are not detected in time. One of the most common pathologies is fetal bradycardia.

General information about the disease

Theoretically, a painful condition can develop at any time, but special vigilance should be exercised when the gestational age has reached the mark of 29-30 weeks.

Embryonic bradycardia is a complication that occurs in the fetus, characterized by abnormal heart rhythms. Speaking without scientific terms, then such a pathology is a decrease in heart rate in the fetus. Doctors usually make a similar diagnosis if heart contractions drop to around 110 beats per minute.

On average, the fetal heart rate rises by three to four units every day until the ninth week of pregnancy. Thus, the pulse can reach up to 175 beats and this is quite normal. Further, the following dynamics are observed:

• 12 weeks - 162 strokes;
• Week 13 - 159 strokes;
• 14 weeks - 156 strokes.

That is, proportional reverse dynamics begins. The heart rate of the fetus is decreasing. These changes are directly related to the formation of the nervous system and work internal organs in an unborn child.

Symptoms of pathology

When it comes to complications of fetal development, it is very difficult to independently determine the signs of the disease. During pregnancy, this is the main task of the attending physician, since only routine medical examinations will reveal the pathology.

In fact, doctors define bradycardia based on the above heart rate. That is, if the age of the embryo and the heart rate do not match, then doctors automatically make a similar diagnosis, and recommendations are made to correct the situation.

The first diagnosis should be carried out no later than the twentieth week. Then the doctor usually listens to the heart rhythm every week.

Diagnosis of fetal bradycardia

A professional can easily detect bradycardia using modern methods. At the same time, it is important that the diagnosis be confirmed by at least two methods, and not just one, in order to reduce the risk of medical error. Diagnosis can be carried out in four different ways:

• Standard ultrasound - you can determine the heart rate, although the main purpose of ultrasound is still to fully study the structure of the fetus and the size of its internal organs.
• Auscultation is the most available method passed down to us from the last century. Previously, every gynecologist was able to determine the position of the child in the uterus using a special device. Theoretically, an experienced doctor can also diagnose bradycardia, but high professionalism is needed here, since it is required to find the most comfortable position in order to listen to the child's heartbeat. Very often, this is simply impossible to do, since amniotic fluid interferes with such a procedure.
• Cardiotocography is a more modern method that allows you to synchronize the fetal heartbeat and uterine contractions. The main difficulty is that this method can be used starting only from the 32nd week of pregnancy. The method allows almost one hundred percent to make the correct diagnosis and identify bariccardia.
• Phono-electrocardiography - in this case, the electrical impulses of the heart are recorded. From a medical point of view, this method combines the more modern phonocardiography. In fact, thanks to this method, it is possible to obtain the most detailed report on the heart rate.

Ultrasound, CTG

Consequences of a complicated condition

Bradycardia, of course, is not a fatal disease for the fetus, however, this condition cannot be left to chance. Such violations can symbolize global problems during pregnancy and childbirth. Especially dangerous is bradycardia later dates. A painful condition can threaten with very unpleasant consequences for the child, therefore, if possible, doctors in such cases perform a caesarean section.

With bradycardia, even in early pregnancy, the fetus does not receive enough oxygen. If this condition continues for a very long time, it may develop. Accordingly, such a neglected condition already threatens with intrauterine growth retardation of the fetus, as a result of which the child may be born defective. During the period of complications, there is a possibility of the birth of a child with Down syndrome, Edwards, Patau or other terrible and incurable disease.

Prolonged bradycardia without adequate treatment can provoke preterm labor and placental abruption in the later stages. That is why often doctors, comparing the risks, make a decision in favor of caesarean section to save a child's life. Naturally, the state of health of the mother is also taken into account, since caesarean section itself is contraindicated in some cases. Doctors are always obliged to make a choice in favor of a woman's health.

The worst outcome is intrauterine fetal death. This is possible with a sharp drop in blood pressure.

Causes of the disease

The most common cause of fetal bradycardia is an unhealthy lifestyle. First of all, this applies to cases where the expectant mother abuses alcohol, cigarettes or drugs. In such cases, the risk of disease increases by forty percent. Moreover, when bradycardia is caused by systematic poisoning of the body, the course of the disease is more difficult, increasing the risk of fetal death.

Other causes of the illness are unrelated to the mother's lifestyle and include:

• the presence of chronic diseases;
• congenital anemia;
• constant stress;
• prolonged toxicosis;
• entanglement of the fetus with the umbilical cord;
• multiple pregnancy.

When such a diagnosis is made, they are usually immediately placed in the hospital for preservation, trying to stabilize the condition of the fetus.

Treatment of bradycardia

There are no specialized drugs for the disease itself. Usually the main goal of doctors is to identify the systemic cause that caused an unpleasant condition. Further, based on this, treatment tactics are prescribed.

Medicines are prescribed mainly only to combat the chronic disease that provoked bradycardia. If, for example, anemia was the cause, then drugs will be prescribed precisely to support the body in the fight against this disease. Usually drugs are prescribed to compensate for the lack of iron.

Prevention of bradycardia

The basis in the tactics of combating the disease is not treatment at all, but its prevention. To reduce the risk of an unpleasant condition will help:

• adjusted regime of the day and rest;
• proper nutrition;
• complete rejection of bad habits;
• the use of additional vitamin and mineral complexes.

Preventive measures will help to avoid long and complicated treatment in most cases. If you do not take cases with chronic diseases, then according to statistics, it is the wrong lifestyle of a pregnant mother that often provokes an incorrect heart rate in the fetus.

Bradycardia is not a sentence for a pregnant woman, but definitely an occasion to think about your health.

If problems with heart contractions in a child were provoked by an unhealthy lifestyle, then it is urgent to abandon all possible bad habits.

In the case of chronic diseases, it is important to follow the doctor's instructions and probably go to the hospital for preservation. In itself, this painful condition is not fatal to the fetus, but without adequate precautions and treatment, it can provoke fatal consequences.

Video: Bradycardia

Bradycardia in pregnant women is divided into 3 types. Separation occurs for characteristic reasons and mechanisms for the appearance of a rare pulse:

There are 3 types of bradycardia in pregnant women, namely sinus, against the background of heart-type blockades and on the basis of arrhythmia. The division occurs depending on the mechanism of development and the reasons that provoked a decrease in heart rate and other factors:

Fetal bradycardia can occur in two ways:

• basal;
• decelerant or sinus.

Basal bradycardia, subject to its timely treatment and correction of the factors that caused the appearance, does not pose a threat to the fetus and pregnancy in general.

The heartbeat drops to 110-120 beats per minute. This indicates fetal hypoxia, which occurs due to iron deficiency anemia in the mother, a drop in her blood pressure, or compression of the fetal head.

Sinus bradycardia is a more serious condition. The fetal heart rate drops to 70 beats per minute, which indicates the need for urgent medical care.

Mother prescribed bed rest, treatment is carried out only in a hospital and continues until the moment of delivery. Sinus bradycardia often leads to pregnancy failure.

Starting from 8 weeks of pregnancy, a regular visit to the doctor allows you to determine at an early stage a decrease in heart rate in 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.

Causes

Possible reasons for the development of PD include: 1). Conditions leading to hypoxia in a child (i.e., a decrease in the amount of oxygen in the blood of the fetus)

From the mother's side:

• anemia in a pregnant woman
• bad habits (smoking, drinking alcohol, drug addiction)
• diseases that have a chronic course (exacerbation stage)
• oligohydramnios, polyhydramnios
• multiple pregnancy
• placental pathology (abruption, malposition)
• prolonged toxicosis
• infectious diseases
• reception medicines that have a toxic effect on the baby

From the side of the fetus:

• umbilical cord pathology and related complications
• malformations
• metabolic pathology

2). Violation of cerebral circulation in the fetus.

Both at the beginning of pregnancy and in the last trimesters, a woman's body begins to experience tremendous stress, including on the cardiovascular system. Against this background, the heart rate can both increase and decrease, and this does not always indicate the presence of any pathology. Some may cause a problem. medications, chemical components. It also develops against the background of pathologies of the heart of an inflammatory nature or affecting metabolic processes. These are myocardial dystrophy, ischemia, myocarditis. Less dangerous causes of bradycardia include:

• problems in the gastrointestinal tract;
• stressful situations, especially if the nervous system is weakened;
• pathology of the respiratory tract;
• inadequate diet, bad habits;
• diseases of the endocrine sphere;
• dysfunction of metabolic processes.

Sinus bradycardia, even of a pathological nature, is not considered an indication for medical abortion. Moreover, it rarely causes a significant deterioration in the condition.

In any of the trimesters of pregnancy, the female cardiovascular system is faced with significant stress. Due to this:

• the frequency of contractions of the heart muscle (HR) in her changes upwards;
• in some cases, during pregnancy, heart rate indicators systematically decrease, that is, bradycardia is formed;
• far from always this should be taken as a sign of a serious illness and, in the vast majority of cases, this is not accompanied by unpleasant manifestations.

It should be noted that the heart muscle is able to contract on its own under the influence of those impulses that are formed in it.

Automatism is guaranteed by the conduction system of the heart, namely the specific muscles that run along its array. Thus, they form branches (bundles) and concentrations of cells (nodal components).

The cardiac conduction system includes nodes that are located in the atrium and at the junction of the atria and ventricles. The same "organism" includes bundles extending from them, conducting excitation to the very heart.

At its core, bradycardia is one of the many signs that something is wrong with the baby’s health, and that he is literally suffering.

When causes in a pregnant woman: not healthy lifestyle life future mother(malnutrition, bad habits or a sedentary lifestyle);
the use of drugs that are prohibited for pregnant women or have a negative effect on the fetus;
anemia of a pregnant woman (not only those that were before conception, but also those that formed in the process of bearing a baby);
severe toxicosis;
prolonged stressful conditions;
blood flow disorders and convulsions;
Rhesus conflict that does not stop;
multiple pregnancy;
pathologies associated with placental abruption, its presentation, infarction;
heavy infectious diseases future mother;
little or polyhydramnios.

The main reasons may lie in the mother, or may be directly in the state of the fetus.
Violations in the body of the fetus: congenital pathologies of the respiratory and cardiovascular systems;
torsion or squeezing of the umbilical cord;
violation of cerebral circulation;
anomalies of fetal development;
entanglement of the umbilical cord.

There are several reasons that can explain the development of bradycardia in the fetus in the womb:

• the unhealthy lifestyle of the future mother: non-compliance with the diet, the presence of bad habits, the abuse of junk food, a sedentary lifestyle;
• the use of drugs that have toxic properties, adversely affecting the fetus;
• diseases affecting the cardiovascular and respiratory system, which are in the chronic stage;
• anemia, both those that were before pregnancy and those that developed during its period;
• transferred stressful impact, especially in the early stages;
• congenital malformations that can affect both the heart itself and nervous system;
• the presence of a Rh conflict, the therapy of which is not carried out;
• pregnancy with multiple fetuses;
• polyhydramnios or oligohydramnios;
• severe toxicosis;
• development of premature detachment of the placenta;
• entwining the child with the umbilical cord.

Developing bradycardia requires more rapid intervention in order to find and eliminate or at least reduce the pathogenic effect. Prolonged lack of oxygen can be detrimental to the child, leading to severe malformations.

If bradycardia is detected in the fetus, this indicates that the woman's condition should be closely monitored, and the presence of a neonatologist is desirable during childbirth.

For various reasons, the heartbeat of the unborn baby may slow down. The first fetal auscultation is performed at 20 weeks. If there is a suspicion of bradycardia, the woman will be under constant control until the birth. Causes of fetal bradycardia:

influence factor	Cause
External	bad habits of a woman - smoking, drugs, alcohol;
	trauma during pregnancy with damage to the fetal circulatory system;
	emergency operations during pregnancy;
	continued use of contraceptives at the beginning of pregnancy;
	stress during pregnancy;
	malnutrition - diets, observance of religious rites;
	taking analgesics or beta-blockers
Internal	severe toxicosis;
	Rhesus conflict without treatment;
	detachment or insufficiency of the placenta;
	multiple pregnancy;
	polyhydramnios or oligohydramnios;
	clamping or entanglement of the umbilical cord;
	preeclampsia;
	malformations (triad and tetrad of Fallot)
Mother's illnesses	chronic diseases of the heart and blood vessels;
	chronic respiratory diseases;
	diabetes;
	anemia;
	hypotension;
	eclampsia;
	infectious diseases

Bradycardia during pregnancy may be due to a malfunction of the placenta. This temporary organ performs several functions - transport (blood supply to the fetus), endocrine, metabolic. Any failure in its work leads to a decrease in the supply of nutrients and oxygen to the fetus.

Fetal bradycardia can develop due to the following reasons:

Diagnostics

Having identified only bradycardia, the doctor cannot determine what violations are in the development of the fetus, since additional, more detailed examination methods are required (Doppler, ultrasound, etc.).

) Bradycardia, after the 20th week of pregnancy, is a signal for further examination of the fetus in order to identify existing disorders.

Methods used to monitor the condition of the fetus:

1) Ultrasound. In the early stages, a transvaginal sensor is used to determine the fetal heartbeat, and the use of a transabdominal sensor is possible only from the 7th week of pregnancy.

This is due to the physiology and anatomy of the development of the heart in the fetus (by the 7th week, contractions become more frequent and are no longer provided by individual cells, but by a fully formed heart, which is also stimulated by the nervous system).

• 5-10 weeks pregnancy - the study is carried out to finally establish the fact of pregnancy, to exclude atypical (pathological) attachment gestational sac(For example, ectopic pregnancy); determination of the first heartbeats of the embryo (HR about 15-40 beats / min)
• 12-14 weeks - pathologies of fetal development are detected; Heart rate 150-165 beats / min.
• 24-26 weeks - determine the compliance of the development of the fetus with the timing, the sex of the unborn child, examine the placenta; Heart rate 130 - 140 beats / min.
• 30-34 weeks - dopplerometry of the vessels of the uterus and fetus. This method is a type of ultrasound diagnostics. It allows the doctor to see how well the vessels of the placenta and umbilical cord are working, whether there are any obstacles to the blood flow to the baby. Heart rate 130 -140 or more beats / min.
• 34-36 weeks - it is determined whether the placenta is located normally, whether there are any pathologies in it. Heart rate 110-130 beats / min.

2) CTG (cardiotocogram) study of the fetal heart rate over a period of time using a sensor that is superimposed on the abdomen in the place where the fetal heart is closest. A study is conducted at 32 and 36 weeks of pregnancy according to indications. CTG is mandatory for:

• fever in a pregnant woman above 38 ° C
• scar on uterus
• premature birth
• preeclampsia
• postnatal pregnancy (with the help of CTG, the doctor makes sure that the child is alive)
• IUGR (intrauterine growth retardation) - a condition in which the duration of pregnancy does not match the signs of fetal development
• palpitations on fetal auscultation
• stimulation of labor

3) The fetal ECG is not used in all cases, but only in those when there are indications, which include:

• palpitations recorded in other studies
• fetal heart abnormalities according to other studies
• pregnant woman over 38 years old
• congenital pathology of the cardiovascular system in a pregnant woman
• endocrine diseases in the expectant mother (such as diabetes mellitus, hyper- or hypofunction of the thyroid gland, etc.)
• suffered a serious infectious disease during pregnancy
• the birth of children with malformations.

4) Auscultation with an obstetric stethoscope. For the first time, a primiparous woman begins to feel the movements of the fetus at the 20th week of pregnancy (a woman giving birth not for the first time feels the movements of the fetus, usually at 18-19 weeks of pregnancy).

With the help of an obstetric stethoscope at the same time of pregnancy, it is possible to listen for the first time to a weak fetal heartbeat. With this type of diagnosis, the woman lies calmly on her back and breathes at her usual pace.

However, there are cases when this cannot be done using auscultation (polyhydramnios or oligohydramnios, excessive activity, the mobility of the child at the time of auscultation, pronounced subcutaneous fat on the anterior wall of the abdomen in a pregnant woman, placenta previa to the anterior wall of the uterus).

Progressive bradycardia with the formation of attacks of weakness requires a mandatory examination of the expectant mother.

Problems with the process of bearing a child are formed exclusively with aggravated lesions of the heart muscle, which are accompanied by serious violations in the holistic state. It can be not only Morgagni-Adams-Stokes attacks, but also destabilization of the circulatory process.

The management of pregnancy and childbirth in the presented situation is carried out according to an individual algorithm and involves frequent scheduled examinations and examinations. Diagnosis consists in a full examination of the body:

• testing (blood, urine);
• visiting a cardiologist and joint consultation with a gynecologist;
• if necessary, X-ray and other hardware methods of diagnosis.

The slowing of the fetal heart rate is fraught with serious consequences, the most severe of which is its intrauterine death. During bradycardia in the fetus during pregnancy, oxygen starvation occurs, which is extremely dangerous for the development of its systems and organs and causes its delay.

In any case, even a single episode of a decrease in fetal cardiac activity requires a thorough examination.

Also, expectant mothers who have chronic diseases or serious health problems in history should undergo regular screening. Diagnostics includes:

1. auscultation. It is carried out from 20 weeks to all pregnant women.
2. Ultrasound includes 4 screenings during pregnancy:

• at 11-13 weeks to determine the gestational age and fetal heart rate;
• at 20 - 23 weeks to determine the condition of the fetus, its heartbeat and the condition of the placenta;
• at 30-34 weeks, dopplerometry of the uterus is performed to assess blood flow and the state of the cardiac and vascular systems
• at 36 - 37 weeks to assess the condition of the placenta.

1. CTG (cardiotocography). It shows the state of the fetus and uterine vessels.
2. Electrocardiography is performed at 5-6 months only if the fetus develops with a delay or other examinations revealed heart pathologists.
3. Phonoelectrocardiography is intended for ascertaining noises and determining the heart rhythm.

In the first months, the only possible way to control the fetal heart rate is ultrasound. From the 20th week - this is auscultation in combination with ultrasound. Starting from the 8th month, CTG and dopplerometry are used.

The main types of diagnostics are ultrasound, CTG (cardiotocography) and doppleroscopy. The number of times and intervals between examinations are determined by the attending gynecologist.

More frequent blood and urine tests may also be needed. In addition to heartbeats, the heart muscle itself is examined.

To carry out a complex of therapeutic measures aimed at restoring the normal heartbeat of the fetus, pregnant women are recommended to be treated in a hospital under round-the-clock supervision of doctors.

Late fetal bradycardia may in some cases be an indication for caesarean section. The main goal of therapeutic measures is to stabilize the condition of the child and carry the pregnancy to the full term.

A pregnant woman should be registered with a gynecologist before the 12th week of pregnancy. There are a number of surveys that should be carried out according to the schedule. Some types of diagnostics are carried out no more than 2 - 3 times for the entire period. If pathology is present or suspected, the range of examinations can be expanded. Fetal bradycardia is easy to detect using the following methods:

1. Phonoelectrocardiography. A method that combines ECG, which records the electrical impulses of the heart, and phonocardiography, which records sound phenomena. This allows you to determine the frequency and rhythm of heart contractions, characterize heart sounds or identify additional pathological murmurs.
2. Cardiotocography. This method allows you to make a synchronous recording of the fetal heartbeat and uterine contractions. Carried out using a cardiotocograph apparatus starting from the 32nd week of pregnancy. The device is attached to the belly of a pregnant woman or inserted into the vagina. This method makes it possible to assess the nature of the fetal cardiac activity, its motor abilities and the contractility of the uterus.
3. Ultrasound study. During the period of pregnancy, a woman should perform this examination three times. The screening method allows you to determine the size of the fetus, carefully study the structure of its internal organs. During the examination, the heart with its own ventricles and valves, the head with the structural components of the brain, and bone tissue are clearly visible. You can also determine the heart rate.
4. Auscultation. A simple, affordable method used by all obstetricians and gynecologists when examining a pregnant woman. A conventional phonendoscope or a special gynecological stethoscope determines the position of the fetus in the uterus. Then, in the most advantageous position, the child's heartbeat is heard. Sometimes it cannot be determined due to high water, transverse presentation, missed pregnancy.

According to the classification, fetal bradycardia is of two types, depending on the heart rate. With basal bradycardia, a heartbeat of 110 beats per minute is noted.

Timely detection and treatment does not lead to malformations. Decelerant bradycardia is accompanied by a significant decrease in heart rate to 90 per minute.

Such a long-term condition leads to fetal hypoxia and irreversible consequences for the unborn child.

Treatment

Everyone knows that it is easier to try to avoid the disease than to spend considerable effort on its treatment. Measures to prevent bradycardia include:

• adjustment of the daily routine of a pregnant woman;
• exclusion of bad habits;
• a woman's compliance with the doctor's recommendations on nutrition, physical activity, etc.
• treatment of chronic diseases in pregnant women.

Controlled bradycardia in early pregnancy and beyond does not require treatment. However, such a woman should always be under the supervision of a specialist.

This will make it possible to keep the heart rate indicators and the functioning of the heart muscle under close attention. With bradycardia, which is difficult to control, individual symptomatic treatment is prescribed.

It is necessary to avoid stressful situations that adversely affect the work of the heart. You need to get enough sleep every day and use only useful natural products.

Treatment of bradycardia begins with prevention. It includes:

• normalization of mother's day regimen;
• rejection of bad habits;
• compliance with recommendations on diet and physical activity;
• in the presence of anemia, iron-containing drugs are prescribed;
• in the presence of chronic diseases, therapy is carried out aimed at eliminating their symptoms or reducing the likelihood of exacerbation.

The second stage of treatment is the constant monitoring of the condition of the fetus:

In another publication, our experts will tell,

how to treat bradycardia

We will share important information about nutrition for heart bradycardia here.

In another article there is a description of the differences between tachycardia and bradycardia.

With a long pregnancy and a significant degree of bradycardia, the obstetrician-gynecologist may decide that it is necessary to terminate the pregnancy with a caesarean section in order to avoid the development of more severe pathologies in the fetus.

After 30 weeks, in the presence of persistent fetal bradycardia, the doctor may decide on a premature delivery by caesarean section. This is done in order to exclude the further development of pathologies.

If bradycardia does not threaten pregnancy, the efforts of doctors are directed to the elimination of the factors that cause it. Drug treatment includes the use of the following drugs:

• ginipral or papaverine, which relieve the tone of the uterus and reduce fetal hypoxia;
• vitamins (ascorbic acid, iron preparations for anemia);
• glucose;
• magnesia (with preeclampsia and preeclampsia).

Other elements of treatment are:

• rejection of bad habits;
• adherence to a therapeutic diet;
• compliance with sleep and rest;
• decrease physical activity;
• walks in the open air;
• maintaining immunity.

It has become more difficult for a modern woman to bear a child due to the negative influences of modern life - stress, unhealthy diet, bad ecology. Therefore, medical supervision, from early pregnancy to the very birth, is a vital necessity to ensure the birth of a healthy child.

Bradycardia in children requires treatment only in case of circulatory disorders associated with it - dizziness, attacks of weakness, etc. First of all, the main diseases that caused the appearance of bradycardia, such as heart defects or myocarditis, are treated.

In addition, drugs that accelerate the heart rate (caffeine, belladonna and others) are prescribed.

Examination is necessary to identify the causes of childhood bradycardia. Only the attending physician, based on its results, will prescribe adequate treatment.

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

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

Treatment of fetal bradycardia in the early stages should begin with conservative methods. Episodes of a prolonged decrease in the frequency of heart contractions in the first trimester can provoke an abortion.

In this case, the woman should lie down for preservation in the maternity hospital, be examined. Drug therapy is reduced to the intravenous administration of drugs such as magnesium sulfate, papaverine, glucose.

After that, it is imperative to monitor the cardiac activity of the fetus with the help of ultrasound, to take preventive measures.

Prolonged bradycardia in late pregnancy can cause premature birth, abortion, placental abruption, intrauterine fetal death. Treatment starts immediately. The woman is hospitalized in the department of pathology of pregnant women. Comprehensive treatment includes physiotherapy exercises, reflexology, medication. Intravenously administered:

• magnesium sulfate;
• papaverine;
• prifinium bromide (Riabal);
• lucose;
• ascorbic acid;
• ginipral.

If it is possible to save the pregnancy, the expectant mother is discharged from the hospital home and awaits the expected date of birth. If a miscarriage occurs, treatment is continued. He is sent to restore the woman's health. Doctor's recommendations should be strictly followed.

In the III trimester (at late pregnancy) the formation of all organs of the child is completed. If during this period the fetal bradycardia lasts more than 2 days, and drug therapy does not help, the gynecologist must make an appropriate decision.

The doctor may resort to natural or surgical delivery. Such actions will save the child from severe pathologies of the nervous system.

Prevention:

Preventive measures taken in bradycardia are directly related to the prevention of other cardiovascular diseases. In addition, it is necessary to lead a healthy lifestyle, which consists in:

• maintaining constant physical activity;
• healthy eating;
• maintaining an optimal body index;
• control of indicators of cholesterol and pressure;
• absolute cessation of smoking;
• limiting the consumption of alcoholic beverages.

You should also 100% exclude from your menu products such as pork, lard, fatty varieties of cheese, as well as flour and fried products.

Subject to the measures presented, bradycardia will be defeated and the woman will be able to calmly take up pregnancy and thoughts about the child.

It is important to remember that this pathology needs constant monitoring and consideration of all symptoms. This is necessary in order to maintain the health of the expectant mother and her child.

The best prevention is considered to be the prevention of the effects of the main probable causes. In addition, it insists on the complete exclusion of bad habits in a pregnant woman, proper nutrition, a rational balance of work and rest, as well as timely scheduled visits to a gynecologist.

Symptoms, causes, diagnosis and treatment of sinus arrhythmia

Pregnancy is a rather difficult and responsible period in the life of every woman. She should be attentive to her health, as the expectant mother is responsible not only for herself, but also for the child. It is very important in this period to detect the development of diseases and disorders in a timely manner. 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 scan in the fifth week. Until this period, any listening to the heart rhythm is not informative. The procedure is carried out only from 11 to 13 weeks in order to confirm pregnancy.

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

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

The disease in medicine is 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. Her pathology carries a danger to the body of the mother and baby, and is also not the cause of the development of serious consequences. With timely diagnosis, basal bradycardia can be completely cured.
2. Decelerant. The heart rate drops to 90 beats per minute. The cause of development is hypoxia, when the fetus does not have enough air. This provokes the occurrence of irreversible changes and requires immediate treatment.
3. Also isolated. It is a kind 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 help from specialists, the fetus may die. The risk of pregnancy fading increases. That is why, when establishing this type, a 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 wrong lifestyle of a young mother: a woman drinks alcohol or drugs, smokes. The provocateur of the development of bradycardia in the fetus also become:

1. Insufficient amount of vitamins in food.
2. Rare walks in the fresh air, as a result of which the child experiences a lack of air.
3. Cardiovascular disease or lung pathology established in a woman.
4. anemia.
5. infectious diseases.
6. Stress or nervousness.
7. Exposure to toxic substances that adversely affect the condition of the baby in the womb.
8. Toxicosis, occurring for a sufficiently long time in severe form.
9. Low water.
10. Entanglement of the fetus by the umbilical cord.
11. Placental abruption occurring prematurely.
12. Deviations in the development of the embryo.
13. Polyhydramnios.

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

Symptoms

It is difficult to establish the presence of the disease, since the woman does not show symptoms. Often, the expectant mother feels good, and a slight deterioration in 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 sudden respiratory arrest. A slow heart rate can also be set while walking.

Can be identified through ultrasound on the following grounds:

1. Deterioration of the heart muscle.
2. Slowing of the fetal movement, there may be a stoppage of movement.
3. Rare breathing or its periodic stop.
4. Presence of seizures.
5. Cardiac arrest or a critical reduction in the number of heart beats.

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

1. Freezing movement.
2. Seizures.
3. Paleness of the skin or cyanosis.
4. Heart failure.

This condition requires the immediate help of specialists, as the risk of a missed pregnancy and fetal death increases significantly.

Treatment

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

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

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

1. Observe the regime of work and rest.
2. Reduce physical activity.
3. Regularly take walks in the fresh air.
4. Follow a diet.
5. Maintain immunity.

The heart rate, subject to all the rules, can improve. But the observation of doctors is carried out not only during the period of gestation, but also after childbirth.

Bradycardia may not always be a threat to the health of the 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 20 weeks. To prevent the development of a violation, the expectant mother needs to take her health seriously and observe the following preventive measures:

1. Refrain from drinking alcohol and smoking.
2. Eat properly. The diet should include not only fresh fruits and vegetables, but also nuts, dairy products.
3. Be outdoors regularly.
4. Observe the regime of work and rest.

Of particular importance is a good sleep. A healthy person should sleep at least 8 hours. But the female body during pregnancy experiences serious stress. That 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 bradycardia is in the fetus and what danger it poses to the baby. The prognosis depends on the degree of development, the state of health of the woman, 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.

Bradycardia is a decreased heart rate. Surprisingly, cardiac bradycardia in children is not uncommon. For example, it leads to a congenital reduced frequency of the pacemaker - the sinus node. But more often, the cause of bradycardia can be a general intoxication of the body or some diseases. In any case, bradycardia in children is a reason to see a doctor with them.

Often there is bradycardia in the fetus during pregnancy. 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 syndromes, etc.). If fetal bradycardia appears at week 6, then its intrauterine development requires special monitoring, since there is a high risk of heart defects, CNS disorders and other severe abnormalities.

If bradycardia in the fetus during pregnancy manifests itself after 8 weeks, then this rather indicates that the placental circulation is disturbed - 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 permanent or only prolonged. If the heart rate recovers after some time or even exceeds the norm, then, most likely, the immaturity of the automatism of the sinus node is evident, 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 disease in the fetus. In this case, close monitoring is required.

Causes and types of pediatric bradycardia

Electrical impulses that arise 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 bundles-branches from them, which 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 atrium and ventricles.

Sinus bradycardia in a child can be caused by a congenital decrease in the automatism of the pacemaker - the sinus node. Compression of the vagus nerve and birth trauma can lead to pathological sinus tachycardia.

If a child has a slow pulse that does not cause serious impairment of the condition, then such sinus bradycardia does not require treatment. For example, against the background of diseases of the endocrine and nervous systems, intoxication may cause mild bradycardia in children.

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

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

Manifestations of different types of bradycardia in children

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

heart rate in children different ages differs, but it is in any case higher than that of an adult. For newborns, a decrease in heart rate below 100 beats is already considered bradycardia, in babies 1-6 years old it is 70 beats, and in adolescents it is below 60.

Usually mild bradycardia in children does not cause circulatory disorders and has no consequences.

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

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

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

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

• Suddenly, the child 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, respiratory and cardiac arrest.
• After the resumption of the work of the heart, 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 main diseases that caused the appearance of bradycardia, such as heart defects or myocarditis, are treated. In addition, drugs that accelerate the heart rate (caffeine, belladonna and others) are prescribed.

Examination is necessary to identify the causes of childhood bradycardia. Only the attending physician, based on its results, will prescribe adequate treatment.

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

The fetal heart rate is monitored throughout the entire pregnancy in order to track the dynamics of its development, a favorable condition. The phenomenon of slowing the rhythm can be diagnosed in the early and late stages of bearing a child.

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

Determination of heart rate

In the first and second trimester, doctors use different methods assessment of the work of the body:

• transvaginal examination is performed on early term, 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 gestation, a cardiotocogram (CTG) is done. The technique resembles the removal of an electrocardiogram and allows you to determine the contractility, excitability and conductivity of the fetal myocardium.

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

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

Norms at different stages of pregnancy

The norm of the heart rate of the embryo is 110-170 beats/min. The indicators differ at different gestation periods 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 rate of rhythm is relative. Doctors are faced with the task of making sure that there is no missed pregnancy.

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

In the last trimester, to diagnose the 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).

Correspondence table of heart beats by week:

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

Interesting fact! The value of the parameters is influenced physiological features women in labor, her emotional state, genetic factor.

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

Deviations from the norm

A poor heartbeat at the beginning of the term with an embryo length of up to 8 mm may be a consequence of a missed pregnancy.

Listening to fetal tachycardia is sometimes the result 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 exclude iron deficiency anemia.

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

Causes of bradycardia include:

• fetal hypoxia;
• fetoplacental insufficiency;
• breech presentation;
• much or little water.

The tactics of treatment is determined after an additional examination and elimination of unfavorable factors. Sometimes the decrease in rhythm is due to a hereditary factor and does not pose a danger to the baby's cardiovascular system.

Slow heart rate in the fetus

The diagnosis is established at rates below 110 beats / s. for more than 10 minutes. Bradycardia in the first trimester is a consequence of previous rubella and other infectious diseases, exposure, poor ecology in the area of ​​residence.

Among the reasons for a decrease in heart rate:

• fetal hypoxia, accompanied by an increased content of potassium and acidosis;
• cardiac anomalies;
• cord entanglement;
• Rhesus conflict;
• developmental delay;
• earlier exfoliation of the placenta;
• prolonged lack of oxygen in the tissues;
• wrong position in the womb;
• the influence of taking medications (beta-blockers).

Before the 8th week, a decrease in the frequency of organ contractions can be caused by chromosomal abnormalities (Down syndrome, Edwards syndrome) and malformations. For diagnosis use double test”, chorion biopsy, amniocentesis.

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 the frequency of the rhythm with repeated episodes;
• true bradycardia.

The least harmless is basal bradycardia. It is recorded when the heart rate drops to 110 bpm. With the appointment of 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 blockade of the organ.

Deceleration is established by determining the heart rate of 110-120 bpm. within 60 seconds. A type of pathology is sinus bradycardia. The number of recorded strokes is 70 bpm. Treatment is carried out in a hospital, the patient is prescribed complete rest until delivery. The risk of pregnancy fading is quite high.

Among the causes of true bradycardia are:

• maternal hypothermia;
• hypotension;
• hypoglycemia;
• squeezing the umbilical cord;
• CMV infection.

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

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

It is important! Indirectly, any disturbance in the movement of the fetus (increase or slowdown) may indicate bradycardia. It is necessary to inform the doctor about this.

Danger of rhythm disturbances

What is the danger of slowing the heart rate? Long-term bradycardia causes severe developmental pathologies. Due to the lack of oxygen saturation, the death of the fetus inside the womb as a result of hypoxia can occur. Treatment consists of administering drugs to the mother's body. Through the common circulatory system, medicinal substances enter the child and normalize his condition.

In case of failure of therapy in late pregnancy, an emergency caesarean section is indicated.

Must be remembered! 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

With stable 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 performance.

If episodes of a decrease in heart rate are repeated, inpatient treatment is recommended. To prevent the development of pathology, the expectant mother needs a lifestyle correction:

1. Give up nicotine, alcohol. Replace tonic strong drinks with juices and green tea.
2. Follow the rest regime, spend more time in the fresh air.
3. The nutrition of a pregnant woman 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 deplete the nervous system, and regularly undergo preventive examinations.

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