Normal fetal heartbeat. How to listen with a stethoscope

The birth of a new life is a great mystery. Today, doctors have devices at their disposal that allow them to “look” into the intrauterine world, and yet we do not yet know all the intricacies of the development of the future person, and we can judge the baby’s condition mainly only by the heart rate (HR). Expectant mothers listen to themselves with anxiety and trepidation, waiting with bated breath for the results of an ultrasound or CTG - is everything okay with the baby? Research protocols usually contain different meanings: A baby’s heart is constantly developing, so fetal heart rate rates can vary significantly from week to week.

The embryo's heart is formed at 4-5 weeks of pregnancy. And already at 6 weeks, the fetal heartbeat can be “heard” using a transvaginal ultrasound sensor. During this period, the baby’s heart and nervous system are still immature, so in the first trimester there are standards that allow the doctor to monitor the development and condition of the child. Fetal heart rate values ​​by week are shown in the following table:

Please note that from weeks 5 to 8 inclusive are given at the beginning and end of the week (increasing heart rate), and from the 9th week of pregnancy - average heart rate indicators and their permissible deviations. For example, a fetal heart rate at 7 weeks will be 126 beats per minute at the beginning of the week and 149 beats per minute at the end. And at 13 weeks, the fetal heart rate, on average, should be 159 beats per minute; indicators from 147 to 171 beats per minute will be considered normal.

It is believed that from 12-14 weeks of pregnancy until birth, the baby’s heart should normally make 140-160 beats per minute. This means that the fetal heart rate at 17 weeks, at 22 weeks, at 30 and even at 40 weeks should remain approximately the same. Deviations in one direction or another indicate that the baby is not well. If the heartbeat is rapid (tachycardia) or slow (bradycardia), the doctor will first of all suspect intrauterine fetal hypoxia. Tachycardia indicates a slight oxygen starvation of the baby, which appears as a result of the mother’s long stay in a stuffy room or without movement. Bradycardia indicates severe hypoxia resulting from fetoplacental insufficiency. In this case it is necessary serious treatment, and sometimes emergency delivery with the help caesarean section(if long-term therapy does not produce results and the fetal condition steadily worsens).

At 32 weeks of pregnancy and later, fetal heart rate can be determined using cardiotocography (CTG). Along with the child’s cardiac activity, CTG records uterine contractions and the baby’s motor activity. In late pregnancy This research method allows you to monitor the condition of the child, which is especially important for pregnant women suffering from fetoplacental insufficiency.

There are other causes of fetal heart rhythm disturbances: diseases of the pregnant woman, her emotional or nervous overexcitation, physical activity(for example, gymnastics or walking). In addition, the child's heart rate depends on his motor activity: During periods of wakefulness and movement, the heartbeat increases, and during sleep the small heart beats less frequently. These factors must be taken into account when studying fetal cardiac activity.

Maria Sokolova

Reading time: 15 minutes

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For any expectant mother, happiness is to listen to her baby’s heart beat. And, of course, every mother knows that a normal fetal heartbeat is one of the main characteristics of the successful development of pregnancy and an indicator of the viability of the baby. Therefore, control over the heartbeat must be constant throughout pregnancy.

What methods of measuring this indicator do specialists use, and what are the standard values?

Fetal heart rate chart in early pregnancy up to 14 weeks

For rate general condition crumbs Heart rate (note - heart rate) is an extremely important criterion, so it is measured at every visit of the expectant mother to the gynecologist.

• The fetus has a heart on .
• During this period, it is a hollow tube without partitions, which is capable of contracting already at the 5th week of development.
• And already by 9 weeks The “tube” turns into a four-chamber organ.

For the baby to breathe, an oval “window” remains in the heart so that oxygen reaches the baby with the mother’s blood. After childbirth, this window closes.

In the early stages, it is almost impossible to hear your child’s heartbeat with a stethoscope. Heart rate up to 8-14 weeks the doctor checks exclusively with the help modern methods diagnostics

In particular, with the help of ultrasound, which is performed with a transvaginal (from 5-6 weeks) or with a transabdominal sensor (from 6-7 weeks).

Table of heart rate norms in early pregnancy:

Fetal heart rate norms during pregnancy from 15 weeks to 42 weeks

Starting from the 15th week, specialists check heart rate using modern instruments.

The normal fetal heart rate is:

All meanings below 120 or above 160- a serious deviation from the norm. And when the heart rate increases over 160 beats/minute talk about initial stage hypoxia.

Moreover, the heart rate depends not only on the baby’s age, but also on his position, directly on the position in the uterus, on his movements, on the nature of the mother’s abdominal tissue, etc.

Methods for determining heart rate - what devices are used to listen to the heart rhythm?

• Ultrasound (note – transabdominal/transvaginal). Using this procedure, they check for the presence of heart defects or other pathologies in the future baby.
• Echocardiography. The method is deeper and more serious, allowing you to analyze the work small heart, its structure, as well as the functioning of blood vessels. Typically, specialists prescribe this diagnostic method after the 18th and before the 28th week. For early and late pregnancy, the method is absolutely ineffective: in the 1st trimester the heart is still too small and not fully formed, and at the end of pregnancy diagnosis is difficult due to the small number of amniotic fluid. Typically, echocardiography is prescribed for those who either have certain diseases, with which they automatically become a risk group. The method is recognized as the most accurate modern one. In addition, it allows you to record the examination and even enlarge the resulting image for subsequent detailed analysis.
• Auscultation. Or, speaking in simple language, use of an obstetric stethoscope. This procedure is performed on expectant mothers at every doctor’s appointment and birth process. Using a stethoscope, a specialist determines exactly how the baby is positioned inside the mother. When the heart beats are clearly heard below the mother's navel, they speak of a cephalic presentation, when the beats in the navel area are heard, they are said to be transverse, and when the heartbeat is above the navel, they are said to be pelvic. The instrument also allows you to determine the nature of heart sounds and the rhythm of its contractions. Thanks to the method, it is possible to promptly detect heart defects or hypoxia. The disadvantage of the method is the lack of its effectiveness in case of high/low water, with multiple pregnancy or obesity of the mother, as well as when the placenta is located on the anterior/wall of the uterus.
• Cardiotocography. Indications for this diagnostic method are elevated temperature or severe gestosis, diabetes and prematurity, a scar on the uterus, hypoxia or aging of the placenta, arterial hypertension, etc. The CTG method is used from the 32nd week and during childbirth: sensors are fixed on the mother’s stomach, and a recording is made within an hour, based on the results of which the heart rate is assessed, as well as the reaction of tones to the baby’s movements or contractions. A heart rate recorded by the device of less than 70 beats/min is a reason to suspect oxygen deficiency or delayed fetal development. However, with breech presentation this indicator considered the norm.

How can you listen to your baby’s heart rate at home?

Every mother would like to listen to the heart of her future little one beating while at home. And in some cases, you simply cannot do without constant heart rate monitoring.

And you don’t have to go to your gynecologist for this - there are also home methods of “wiretapping”.

• Obstetric stethoscope. True, it will be possible to listen to the baby’s heart only after the 21-25th week. And then the mother will not be able to hear him, because it is impossible to carry out this procedure on her own - an assistant is needed.
• Fetal Doppler. And this one ultrasonic device very effective indeed. It is created specifically for use at home after the 12th week of pregnancy. The design of the device resembles CTG machine, but with one difference - different sizes and the inability to create records. Usually it comes with headphones for comfortable listening.

How is the fetal heartbeat during labor measured and what does it show?

As we found out above, small deviations from the norm in heart rate indicators are not always a reason for panic and suspicion of fetal pathology.

Again, the heart rate rate also does not guarantee that “everything is fine.”

Why then do you need to listen to the heartbeat, and what does it give?

• Establishing the fact that pregnancy has actually occurred. For example, at the earliest stage - from the 3rd week, when fetal pulsation already becomes noticeable on ultrasound.
• Analysis of fetal development. Illness and stress are known to speed up or slow down your heart rate. And the baby’s heart muscle reacts to changes even faster. Analysis of its work allows us to draw conclusions about the health of the fetus as a whole.
• Monitoring the condition of the fetus during childbirth. Monitoring your heart rate during labor is extremely important. Doctors must be sure that the baby can cope with the stress, so they monitor the fetal cardiac activity after each contraction.

During pregnancy increased risk condition of the fetus, specialists are required to monitor heart rate throughout the entire birth process - continuously.

For example, when...

1. Hypoxia and IUGR.
2. Early or late birth.
3. Preeclampsia or severe chronic illness of the mother.
4. Induction of labor and use of epidural anesthesia.
5. Multiple pregnancy.

In addition to the obstetric stethoscope, the CHT method is mainly used. It most accurately shows all changes during childbirth and records them on paper tape.

How is the research conducted?

The expectant mother is attached to 2 special sensors on her stomach: one examines the strength and duration of contractions, the other – the fetal heart rate. The sensors are secured with a special tape and connected to a monitor to record the study.

During the procedure, the mother usually lies on her left side or on her back.

However, modern equipment is no longer so demanding.

Fetal bradycardia - causes of rare heartbeat

It happens (usually in the 3rd trimester) that the fetal heart rate value is deviated from the norm. The reason may be external factors, and maybe in the development of pathology.

One of the most common pathologies is bradycardia, in which the heart rate drops to extremely low values ​​- up to 110 beats/min. and below.

Also, one of the signs of bradycardia is a decrease in the activity of the unborn baby, which is usually noted on CHT.

The causes of bradycardia can be different.

Of the main ones:

• Unhealthy lifestyle of the expectant mother. That is, bad habits, abuse harmful products, lack of proper diet, sedentary lifestyle.
• Anemia and severe toxicosis.
• Low water and.
• Stress. Especially those that were transferred in the 1st trimester.
• Taking medications with toxic properties.
• Congenital malformations in a baby.
• Premature placental abruption.
• Chronic diseases of the mother in the respiratory and cardiovascular systems.
• Multiple pregnancy.
• Rhesus conflict in the absence of therapy.
• Entwining the fetus with the umbilical cord.

If bradycardia develops, immediate intervention is required to eliminate or reduce the harmful effects.

In a complex of therapeutic measures the following are used:

1. Diet, strict regime day and giving up bad habits.
2. Compliance with the physical activity regime.
3. Taking medications containing iron.
4. Constant monitoring of the fetus.
5. Therapy, the purpose of which is to eliminate exacerbation and symptoms.

Fetal tachycardia - causes of rapid heartbeat

When heart rate values ​​deviate up to 170-220 beats/min. talk about tachycardia. This deviation is also a cause for concern.

The reasons may also be different.

First of all, the reasons that directly depend on the mother’s lifestyle:

• Stress and overwork.
• Smoking and taking medications.
• Abuse of tea and coffee.

Also, fetal tachycardia can cause maternal health problems:

• Changes in the hormonal composition of the blood and an increase in the level of thyroid hormones.
• Anemia caused by iron or vitamin deficiency.
• Large loss of fluid that occurs after vomiting during toxicosis.
• Endocrine pathologies.
• Cardiovascular diseases.
• Presence of injuries accompanied by blood loss.
• Exacerbation of chronic infections.
• Regular colds, bronchitis, etc.
• Rheumatism at the stage of damage to the joints and heart.

As for embryonic causes, these include:

• Mother's multiple births.
• Fetal anemia due to an improperly formed placenta.
• Presence of intrauterine infection.
• Rh conflict with mother's blood.
• Anomalies in the development of chromosomes.

Diagnosis of tachycardia is carried out using ultrasound and Dopplerography.

Treatment measures include:

1. Strict daily routine, nutrition and activity.
2. A specific diet that includes foods with magnesium and potassium.
3. Drug therapy depending on the pathology, its causes, the form of tachycardia and the need for drugs.

Usually, a change in the mother’s lifestyle is enough for the fetal heart rate to return to normal. But, of course, when pathologies are identified in a child, constant medical supervision is necessary, which is not always possible at home.

All information in this article is provided for educational purposes only; it may not be relevant to your specific health circumstances and does not constitute medical advice. The website сolady.ru reminds you that you should never delay or ignore visiting a doctor!

For every woman preparing to experience the joys of motherhood, the most pleasant and long-awaited sound is the heartbeat of an unborn child. It symbolizes the beginning of a new life and the moments of joy and happiness associated with it.

The heartbeat of the pregnant fetus serves important indicator, according to which the specialist determines such vital factors as blood oxygen saturation, hemoglobin content, features of the anatomical structure of the small heart, hormonal functions and features of the vegetative nervous system.

Fetal heartbeat analysis is performed using different methods, including an obstetric stethoscope, cardiotocography, ultrasound.

Regular monitoring of the baby’s heartbeat in the womb is one of the determining factors in the management of pregnancy and childbirth, making responsible decisions that allow in case of emergency save the baby's life.

When does fetal heartbeat occur?

Already during the 2-3 week period of a child’s development, his heart is formed in the mother’s womb. On at this stage a woman may not even suspect that she is pregnant. The formation of the heart begins with its appearance in the form of a simple tube, which after a couple of weeks acquires an S-shaped bend. For this reason this period in the development of the heart is called sigmoid.

After 4-5 weeks, the primary septum appears, separating the atria, which leads to the appearance of three chambers in the structure of the small heart. From this moment its first contractions begin. Listening to a knock can only be done using an expert-class ultrasound machine. If there are no special indications for such early listening, it should not be used.

During weeks 5-7 of embryo development, an indirect indicator is used to determine the nature of embryo development - the level of hCG hormone (human chorionic gonadotropin).

For measurements, data are taken over time after 2-3 days. Normally, by week 5, the content of this hormone should fluctuate between 1000-3100 mIU/ml. If pregnancy develops normally in the early stages, then the level of this hormone will double every 2-3 days, then its low

Experts believe that analysis for this hormone can be reliable only up to the 10th week of pregnancy. At later stages it begins to fall, and low content during this period corresponds to the physiological norm. This diagnostic method serves as an alternative to ultrasound at the very beginning of pregnancy.

One of the fundamental characteristics during pregnancy, indicating its proper course, is the fetal heartbeat. One of the first methods used to study it by obstetricians is auscultation. It is a physical diagnostic method that allows you to determine the condition of an organ by listening to the sounds it makes.

Typically, the fetal heart is listened to using this method no earlier than 18-20 weeks of gestation. Until this time, the heartbeat is usually weak; in the early stages, for this reason, it is very difficult to hear without the use of special methods.

Fetal heart rate

Throughout pregnancy, the heart rate changes depending on the activity of the heart and the period of development:

• On 6-8 weeks it is not below 110-130 beats per minute;
• On 9-10 weeks– 170-190 beats/min.;
• Beginning from 11th and more later weeks until childbirth it is in the range of 140-160 beats/min.

Such changes are explained by the continuous development of the fetus, during which the formation of the functioning of the autonomic nervous system occurs, which is responsible for the coherence of the work of all internal organs and systems.

For diagnostic accuracy, doctors use special tables that allow them to monitor whether the development of the heartbeat corresponds to physiological norms. What should the heartbeat be like? different stages Pregnancy can be found in Table 1.

Table 1. Physiological norms for the period of embryonic development and heart rate

Purpose of fetal heartbeat detection

Listening to a baby's heart rate before birth is done for several reasons:

Methods for diagnosing fetal heartbeat

The main methods for diagnosing heartbeat intrauterine child serve:

• Ultrasonography;
• Auscultation;
• Cardiotocography (CTG);
• Echocardiography.

Ultrasound is the very first method used to study the condition of the embryo.

Using this method we study:

• Heart rate;
• Fruit size;
• Condition of the placenta;
• Heart sounds;
• Structure of the heart;
• Possible defects, as well as other anomalies, if there are reasons for their occurrence.

Features of ultrasound are shown in Table 2.

Table 2. Ultrasound technique at different stages of pregnancy

The auscultation technique involves listening to the following signs:

• Heart rate;
• Clarity of tones;
• A place to listen to them in the best possible way.

Advantage this method is that it can be used by a person who does not have special education. Using a medical tube, you can easily hear heart sounds and count their number per minute using a stopwatch.

It is important to understand what heart sounds are and their significance as an indicator of fetal development. The normal development of the child's body should be accompanied by clear and distinct sounds of the heartbeat.

If the tones become dull, then this may be a sign of acute and chronic hypoxia.

In rare cases, poor listening tone occurs, which is a sign of the need for additional examination methods.

Other methods are also prescribed if:

• There are changes in the volume of amniotic fluid (increased or decreased);
• In case of multiple pregnancy;
• The woman has overweight and the thickness of the subcutaneous fat cell of the anterior peritoneum does not allow the use of auscultation;
• The placenta is located at the anterior wall.

The cardiotocography method is very informative for assessing the quality of the heartbeat. When used on early stages presence can be detected oxygen starvation baby to take the necessary measures. It is usually prescribed after the 32nd week and before birth.

The machine used in this procedure is an ultrasonic transducer. The signals sent from it are reflected from the heart of the embryo. The changes that occur are recorded on a special film.

Typically, in addition to the main sensor, the doctor uses a contraction sensor in the uterus, which makes it possible to measure its activity, which is of particular importance during childbirth. Modern devices They also have special sensors that record fetal movements, which a woman can even do on her own. The received information is also displayed on the tape.

Recording using this method is carried out with the woman lying on her back. Due to the fact that in the later stages this causes great inconvenience, it may be recommended to take a sitting or lying position on your side.

For this purpose, the sensor is installed on the stomach, where the point of best listening to tones must first be found. The entire procedure is carried out in 40-60 minutes. In some cases, the sensor can be left for a day.

The following indicators are assessed using this method:

1. Fetal heartbeat and characteristic changes that occur during contractions in the uterus.
2. Heart rate.
3. The dynamics of heart contractions (that there are no violations will be indicated by changes in the number of beats within 25 per minute).
4. The appearance of a rapid rhythm in response to contractions in the uterus, which should not occur normally.
5. The appearance of rarer contractions is taken as the norm when pelvic position fetus, but may also indicate acute or chronic hypoxia in other cases.

During pregnancy, CTG is prescribed to each woman at least once.

According to the standards for this method, which establish how the heart should beat, doctors believe that 120-160 beats should be recorded per minute.

There are a number of indications for repeated mandatory use of this method:

1. Late gestosis.
2. The presence of a scar on the uterus due to surgery.
3. Changes in the volume of amniotic fluid.
4. Previous infectious pathologies in which a high temperature was observed.
5. Chronic illnesses of the mother ( diabetes, arterial hypertension).
6. Premature aging of the placenta.

If a detailed study of the structure of the fetal heart and the characteristics of blood flow in its different parts is necessary, echocardiography is prescribed if indicated. It is usually carried out at 18-28 weeks.

Indications for its implementation may be the following:

1. Available birth defects a woman's heart.
2. Birth of previous children with congenital defects.
3. When a woman is over 38 years old.
4. Infections during pregnancy.
5. Presence of diabetes mellitus.
6. Observed delays intrauterine development embryo.
7. Suspicion of the presence of defects in the fetus of both the heart and other organs, which may be combined with disturbances in the development of the heart.

Fetal Doppler is also used as a technique for studying the heartbeat. This is a portable device that you can use at home yourself. The principle of its operation is similar to CTG, but without recording on film. It comes with headphones, allowing you to listen comfortably at home.

You can hear the baby’s heartbeat as early as 8 weeks, but experts recommend using it later, after 12 weeks, if necessary. The duration of the study should not exceed 10 minutes.

Table 3. Pros and cons of portable Doppler

Is it possible to determine the sex of a child by heart rhythm?

In order to determine the sex of the unborn child, there are a number of traditional methods, which in most cases are rejected by doctors.

Heartbeat is important sign according to folk medicine in this question:

1. Listening to the heart rhythm by week You can determine whether a boy or a girl will be born, depending on the clarity and rhythm. Usually this is how a boy’s heart beats, while girls’ hearts beat more chaotically, not coinciding with their mother’s.
2. According to the location of the heart A little to the left predicts the birth of a girl, and to the right - a boy.
3. Because, How many heart beats happens in a minute, you can determine the gender of the unborn child:

Table 4. Number of heart beats in embryos of different sexes

Listening to the heartbeat of an unborn child is an important method for diagnosing the state of his health. It should be used throughout pregnancy.

Video: Determining the sex of the fetus

Doctors use the fetal heartbeat to determine the health status of the unborn child. The heart of an unborn baby can be heard about a month after conception, but in the early stages it is impossible to count the number of beats without special equipment. The frequency of its contractions differs at different stages of pregnancy.

Fetal heart rate norms at different stages of gestation

Sharp changes in indicators are due to the development of the part of the autonomic nervous system responsible for the functioning of internal organs.

The fetal heart rate by week is presented in the table below:

In the fifth week, the heart rate of the unborn baby is the same as that of the mother, and is about 80-85 beats. Over the course of a month, every day this figure will increase by three strokes. By the ninth week, the heart rate will reach 175 beats.

From the 15th week and even after birth, doctors use ultrasound to constantly monitor heart rate, the nature of contractions, rhythm, and location of the heart.

In the second trimester, your heart rate should be between 140 and 160 beats. If the pulse exceeds 160 beats, this indicates the onset of oxygen starvation; if it falls below 120, this indicates acute hypoxia. In this case, the heart rate constantly changes depending on whether the fetus is sleeping or awake, moving or remaining motionless.

Control of the heartbeat is also necessary during childbirth, especially if there are any pathological phenomena. If the pregnant woman reached the end of her term, the fetal heart rate during childbirth is normally 140 beats; if she did not carry it to term, this figure can reach 155.

Continuous heart rate measurement during labor is indicated in the following cases:

• chronic hypoxia and developmental delay;
• birth premature baby or the gestation period has been exceeded;
• induction of labor;
• performing epidural anesthesia;
• gestosis;
• multiple pregnancy;
• heavy chronic diseases at the mother's.

Ways to listen to the heart

There are several ways to determine fetal heart rate. On different dates this is done using different methods.

1. Ultrasound. From 4 to 20 weeks, you can only hear the heartbeat using ultrasound equipment. At the beginning of pregnancy, at 5-6 weeks, the presence or absence of a heartbeat is determined, as well as the number of beats. In the second and third trimesters, the doctor observes the location of the heart and the structure of its parts. Using this method, more than 70% of heart defects are detected.
2. An obstetric stethoscope is used from the 20th week until delivery. During labor, the patient is listened to every 20 minutes, and indicators are assessed before and after each contraction.
3. Phonendoscope - from the 20th week until birth.
4. Echocardiography is indicated in late pregnancy.
5. Cardiotocography is used mainly during childbirth. During pregnancy, it is performed for all expectant mothers once, starting at 28 weeks. In addition to the frequency of beats, contractions of the uterus are recorded and it is determined whether there are any changes in the heartbeat, for example, a slowdown or acceleration.

Echocardiography before the 28th week is prescribed if there is a suspicion of heart defects in the fetus

Why listen to the fetal heartbeat?

Pregnancy is determined by auscultation. Ultrasound equipment allows you to hear heartbeats in the early stages. If they do not appear in allotted time, in the presence of ovum, doctors may suspect a frozen pregnancy, in which case a medical abortion is performed.

Listening allows you to assess and monitor the condition of the fetus throughout the entire period of gestation. The fetal heart reacts to any changes around, be it exercise stress women, stress or illness. The frequency and nature of heartbeats change depending on the phase of rest or sleep, on changes in the concentration of oxygen in the air that the expectant mother breathes. All these phenomena lead to temporary changes in the child's heartbeat. Doctors are usually alarmed by stable deviations from the norm, for example, when the heart beats frequently for a long time. As a rule, such violations indicate hypoxia, or oxygen starvation. If a baby's heart begins to beat too slowly, this is a sign that his condition is worsening. Treatment depends on the stage of pregnancy. Sometimes it is necessary to urgently induce labor.

Heartbeat control is required directly during childbirth, so as not to miss acute hypoxia, so the audition is carried out after each fight. The child's body is subjected to enormous stress during childbirth. This includes hypoxia, compression, and in some cases even placental abruption and compression of the umbilical cord. In such cases, immediate assistance is usually needed.

What do you pay attention to when listening?

The formation of the heart in the fetus begins one of the first, and its work is the most important indicator of the development of the unborn baby and its general condition. Listening is carried out throughout pregnancy and during childbirth. It is thanks to monitoring the heartbeat that pathologies of the unborn child are detected at an early stage.

The myocardium begins to contract around the third week, but the heartbeat appears no earlier than the fifth or sixth week, and is determined only by ultrasound. At the same time, the heart begins to transform from a hollow tube into a full-fledged organ consisting of four chambers - two ventricles and two atria. At 5 weeks, you can only listen to the heart using a transvaginal sensor; this can be done using the transabdominal method no earlier than 6-7 weeks.

When listening, pay attention to the following indicators:

• Heart rate is the frequency of heart contractions. A heartbeat that is too fast (up to 200 beats per minute or more) is called tachycardia, and a heartbeat that is too rare (less than 100) is called bradycardia. Both conditions are considered pathological and require examination, diagnosis and medical care.
• Character of tones. In a healthy heart, the beats are clear and sonorous; with the development of pathology, they become dull and blurred.
• Rhythm. Under normal conditions, the heart beats repeat at regular intervals. With acute and chronic hypoxia (lack of oxygen), as well as with valve defects, arrhythmia is observed.

Video about the possibilities of ultrasound in early pregnancy, including heartbeat examination:

Listening by week

At 6 to 7 weeks, the only way to count the number of strokes is with an ultrasound. If the heartbeat is not heard during this period, there is a possibility of a frozen pregnancy. During the first and second trimesters, using an ultrasound machine, they not only determine the heart rate and the nature of the heartbeat, but also study the structure of the heart in detail to find out if there are any malformations of its development.

From 19 to 22 weeks, the heartbeat can be heard in a simple way- obstetric stethoscope. This procedure is called auscultation, and it is performed during every pregnant woman's visit to the doctor. Listening with a stethoscope is not always possible. For example, this is difficult to do if the expectant mother is overweight, with multiple pregnancies, the placenta is attached to the anterior wall, with polyhydramnios, or, conversely, with oligohydramnios. In such cases, listening by other methods is prescribed.

If, during an ultrasound scan, which is prescribed to all pregnant women, cardiac malformations are suspected, fetal echocardiography (ultrasound of the heart) is required, which is usually performed between 18 and 28 weeks. This method allows you to study all parts of the heart and the blood flow in them. Echocardiography is usually prescribed for patients over 38 years of age, if they or their previously born children have heart defects, if the expectant mother has diabetes mellitus, or if she was ill during pregnancy infectious diseases. Another reason for conducting echocardiography is intrauterine growth retardation of the unborn child.

In the later stages, as a rule, no earlier than 30 weeks, all expectant mothers undergo cardiotocography, during which the heartbeat of the unborn baby is recorded. It makes no sense to do a CTG earlier, since the recordings will be difficult to analyze and decipher. CHT can also be prescribed at an earlier stage if heartbeats cannot be detected by other means. Repeated examinations are required in the following cases:

• with late gestosis;
• with a scar on the uterus after surgery;
• at early aging placenta;
• chronic diseases of women;
• an increase or decrease in the volume of amniotic fluid;
• with delayed development of the fetus in the womb;
• diseases of the expectant mother occurring with elevated temperature;
• transitioning through pregnancy.

Heartbeat recording during cardiotocography

The CTG result is assessed in points:

• from 9 to 12 – the condition is normal, the fetus is not in danger, observations continue.
• from 6 to 8 – moderate hypoxia, treatment may be required, repeat CTG is necessary the next day.
• 5 points – obvious hypoxia, threat to fetal life, indications for cesarean section.

In CTG time determine the basal rhythm and its variability. The first indicator is the heart rate, which normally should range from 110 to 160 beats at rest and up to 190 when moving. Rhythm variability shows how much the average heart rate deviates from the basal rate, and normally should be equal to 5-25 beats/min. Deviations from the norm may indicate disorders in the fetus, but a diagnosis cannot be made based on these parameters alone. Other examination methods are required.

Is it possible to listen to the fetal heart yourself?

Many mothers are interested in how many weeks the unborn baby’s heartbeats can be heard. It is difficult to listen to its beats at home, especially at the beginning of pregnancy. You shouldn't start using a stethoscope before 25 weeks. You can hear the baby’s heart by placing your ear on your stomach from the 30th week. In the early stages (from about 8 to 12 weeks) this is done using modern device– fetal doppler. The device is very easy to use, it can be used without assistants. In addition, it records the heartbeat and is given to relatives to listen to.

Video lecture on fetal CTG (heartbeat study):

Who will be born - a girl or a boy?

Some expectant parents believe that the gender of the baby can be determined by the heartbeat. There is an opinion, although not scientifically confirmed, that a boy’s heart beats less often than a girl’s. At the same time, for a boy it knocks rhythmically and measuredly, but for a girl it knocks chaotically. Therefore, it is believed that by the nature of the heartbeats and their frequency it is possible to determine whether a boy or a girl will be born.

It is unlikely that in this way it is possible to predict what gender the baby will be, and even if everything comes together, it is just a coincidence.

Conclusion

Listening to the fetal heart week by week is an integral and very important part of monitoring the condition of the unborn baby during the entire gestation period. By the nature of the heartbeat and heart rate, you can find out what is happening to it in the womb and provide timely help if necessary.

The heart of a new baby begins to beat as one of the first organs after 1 month of pregnancy, when other organs and limbs are in their infancy. The beating of the fetal heart varies by week of gestation in beat frequency, rhythm and other indicators. Listening to the contractions of the embryo's heart allows obstetricians to judge the health of the unborn baby. From experienced obstetricians you can find out in the early stages whether the baby will be born in 9 months - a boy or a girl.

Medicine cannot explain why a certain group of cells in an embryo suddenly begins to contract and a heartbeat appears. The heartbeat is the only indicator at 4-12 weeks that can be used to determine what is developing inside a woman. new life. Well-perceptible fetal movements, tremors, and blows begin after 16-20 weeks of gestation.

How to determine the heartbeat of an unborn baby

At different stages, the heartbeat of the embryo can be determined using the following methods:

• Ultrasound – from 4 to 20 weeks;
• listening through a phonendoscope - from 20 weeks. before giving birth;
• listening through a tube – from 20 weeks. before giving birth;
• echocardiograph - in the last stages of pregnancy;
• cardiotocograph – used during childbirth.

On initial terms pregnancy, the heartbeat of the embryo is shown by an ultrasound machine. The study is safe for the fetus and allows you to identify possible deviations from the norm. Ultrasound is performed as planned:

• 10-13 weeks – first (transvaginal ultrasound);
• 20-22 weeks – second (transabdominal);
• 32-34 (7-8 months) - third.

To do this, the doctor determines the position of the baby, places a tube on the pregnant woman's stomach and listens to the baby's heartbeat. For experienced gynecologists, such a study provides a complete picture of fetal development by month.

During childbirth or in cases where abnormalities are diagnosed in the future toddler, a carditocograph or echocardograph is used. A special belt with sensors is attached to the belly of a pregnant woman during contractions. The obstetrician listens to the knocking and determines how the uterus contracts, how the baby tolerates childbirth, and whether he is experiencing oxygen starvation.

Normal heart rate

The first contractions of the embryo's heart appear already at 4-6 weeks of pregnancy. Some doctors claim that the heart cells begin to beat in the fetus 12-14 days after conception. Using sensitive equipment during external examination, contractions can be counted at 2 months.

Based on the beating in the first months, an experienced obstetrician can easily determine the gestation period and even the sex of the child. Until 12-13 weeks, the small motor works differently, depending on the period, changing the rhythm and frequency of contractions. A professional gynecologist will be able to tell with great confidence whether the mother will have a boy or a girl based on the heart rate of the embryo. More accurate forecast can be given after 20 weeks. gestation.

So, until 6-8 weeks, the child’s main organ produces 110-130 beats/min. 9-10 weeks - contractions increase to 170-190 beats. From 11 to 13 - contractions decrease, amounting to 140-160 beats/min. From 12-13 weeks. the rhythm and frequency are normalized, set within 140-160 beats until birth. From the 13th week, the obstetrician-gynecologist switches to the auscultation form of examination.

The rate of fetal development is determined by heart rate:

• 7 weeks - there should be 110-130 contractions per minute;
• 12-13 weeks – from 140 to 160 beats per minute.

Fetal heart rate table

If there is a deviation from the norm to a greater or lesser extent, attention should be paid to Special attention supply of oxygen to the fetus, as an indication of accompanying illnesses pregnant. Deviations from the norm may be a consequence of developing pathologies of the embryo, but it is difficult to judge this without additional research.

Muffled tones that can be heard during examination may be a consequence of:

• polyhydramnios;
• availability excess weight in a pregnant woman;
• attachments children's place on the anterior wall of the uterus.

The absence of heartbeats indicates fetal death and requires surgical intervention, artificial stimulation labor activity.

Early sex determination

Official medicine denies the possibility of determining the sex of a child by heartbeat. Numerous experiments have been conducted all over the world, based on the results of which it is possible to predict with 60-70% confidence whether a child will be born - a boy or a girl. In boys, the heart beats faster; in girls, the contraction frequency is slightly lower than 140. The heartbeat of future boys after 12 weeks is more than 140 beats/min.

Predicting gender is complicated by other factors that determine heart rate. A boy or girl can actively move while listening, or vice versa, relax.

As an alternative or in addition to the heart rate counting method, there are folk signs, helping to determine the sex of the future toddler. If it's a boy, the woman will have severe toxicosis, sharp belly, if mom prefers to eat sweets, it means there will be a girl. There are a lot of such signs and, despite centuries-old practice, there are also misfires here.

The method of calculating the heart rate of an embryo is relevant after 12-13 weeks, when the genital organs are formed. In the early stages, sex determination is difficult due to the inconsistent rhythm. But after 20 weeks, you can determine with 100% probability whether a boy or a girl lives in your mother’s tummy using an ultrasound.

Hearing the first heartbeat of your unborn baby is the dream of every woman. By and large to the expectant mother It doesn’t matter whether the baby is born a boy or a girl, the main thing is that the baby is healthy and healthy. And yet, the method of determining the sex of a child by heartbeat remains terribly interesting for young parents. Although with any forecasts at a period of 9 months it will become clear whether a boy or a girl is developing in the mother’s belly.

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When does an embryo have a heartbeat?

The formation of the heart begins already at 2-3 weeks of intrauterine development, that is, at a time when a woman is not even aware of possible pregnancy. During this period, the heart has the shape of a simple tube, which by the beginning of 3-4 weeks begins to bend in an S-shape. That is why at this stage of development the heart is called sigmoid.

After 4-5 weeks of gestation, the primary septum between the atria is formed, as a result of which the heart of the embryo becomes 3-chambered. It is at this stage that the first heartbeats appear. However, in order to reliably record the heartbeat of the embryo at the 5th week of pregnancy, an expert-class ultrasound machine is required. But it is important to remember that in the absence of special indications, performing an ultrasound scan at such an early stage is unreasonable and is not recommended.

In this regard, indirect confirmation of the normal development of the embryo and its heart at 5-6 weeks of pregnancy is the determination of the level of the hormone hCG (human chorionic gonadotropin) over time, after 2-3 days. At week 5, the level of this hormone ranges from 1000 to 3100 mIU/ml. When normal developing pregnancy in the early stages hCG level doubles every 2-3 days. But you need to know that hCG determination reliably only up to the 10th week of pregnancy, because at later stages the level of this hormone begins to fall, which is the physiological norm. Therefore, this diagnostic method is relevant only at the very beginning of pregnancy, as an alternative to ultrasound in very early stages.

Normal fetal heart rate by week of pregnancy

Very important aspect in assessing the cardiac activity of the embryo is knowledge of physiological norms at a certain week of pregnancy. (Contrary to misconceptions, they are no different for future boys and girls!). For convenience, all this data is collected in a table:

Which method of diagnosing fetal heartbeat is the most informative?

There are many ways to monitor the fetal heart, and each of these methods has its own advantages.

Listening with an obstetric stethoscope

This is the simplest and affordable way determine fetal heart contractions. An obstetric stethoscope is a simple funnel. In order to hear the heartbeat, it is necessary to press the wide part of the funnel tightly against the anterior abdominal wall. Such a simple method is effective only with experienced obstetricians. After all, to listen to heart sounds, you need to know where exactly to place the stethoscope. To do this, before auscultation, doctors conduct an external examination of the position of the fetus: determine the presentation (the part facing the pelvis), position (location of the back to the right or left) and type (rotation of the back forward or backward) of the fetus.

Depending on the position of the baby in the uterus, the heartbeat can be heard well in different places:

Auscultation of the fetal heart with a stethoscope is an excellent method that came to modern obstetricians from ancient times. To perform auscultation, you only need a stethoscope and a competent specialist. But this method has one significant drawback: The human ear can recognize heart sounds, usually not earlier than 27-28 weeks of pregnancy. At earlier stages it is practically useless to do this. And if a woman is severely obese or has swelling of the anterior abdominal wall (preeclampsia), you can hear the heartbeat even later, at 29-30 weeks. For this reason, in the first half of pregnancy, other diagnostic methods come to the fore to record heart activity.

Video: rules for auscultation of the fetal heartbeat

Cardiotocography

Cardiotocography is a method of recording fetal cardiac activity using an ultrasound sensor. The data received from the sensor is converted in the cardiac monitor into heart rate, which is displayed on paper in the form of a graph. This method is very good because the recording can be quite long (about an hour, more if necessary), and you can evaluate the work of the fetal heart during all this time. In addition, an undoubted advantage is the simultaneous recording of uterine tone with a second sensor, which is called “tensometric”.

Rules for registering CTG:

1. During the examination, the woman should lie on her side. If the pregnant woman lies on her back, the results cannot be considered reliable, since in this position the uterus can compress the vena cava located underneath it, as a result of which the uteroplacental blood flow is disrupted. This condition is called "inferior vena cava syndrome" and can cause fetal arrhythmias.
2. The ultrasound sensor is placed on the anterior abdominal wall of the pregnant woman in the place where the heartbeat can best be heard, and is fixed with elastic bands. Before starting the study, it is necessary to apply a gel to the surface of the sensor to improve signal conductivity.
3. It is better to install a sensor for recording tone in the fundus of the uterus.
4. Modern devices are equipped with a remote control with a button that the woman must press during the examination when she feels fetal movements. This is a very important diagnostic sign, since it is possible to establish which rhythm disturbances occurred during fetal movement and which ones occurred at rest. This technique is called a non-stress test, since in response to fetal movement, the rhythm normally increases.
5. The cardiotocograph is also equipped with sound devices, with the help of which a woman can hear the heartbeat of her baby. In most cases, it has a calming effect on pregnant women.
6. The study should take about 40 minutes, no less. Increasing the registration time is not prohibited, but a shorter study is not always informative and does not reflect the full picture of the fetal condition.
7. This method can be used from 22-23 weeks of pregnancy.
8. Decipher CTG results Only a doctor can.

Ultrasound examination

The ultrasound method is very informative; its undoubted advantage is the ability to monitor heart rhythm already in the very early stages of pregnancy, when other methods are ineffective. Thus, in the first half of pregnancy, this is the only method for assessing the functioning of the fetal cardiovascular system. In uncomplicated pregnancy ultrasonography carried out three times at appropriate times (10-12 weeks, 21-23 weeks, 31-32 weeks).

Heart rate assessment is carried out in conjunction with other important studies. However, if necessary, you can examine the heart rate, as well as conduct certain non-stress tests more often (for example, in case of fetal hypoxia, disruption of uteroplacental blood flow) in order to monitor the condition of the fetus over time and compare the results obtained with the previous ones. Often such studies are carried out after a certain treatment to evaluate the effectiveness of the therapy.

Video: fetal heartbeat at 7-8 weeks

Video: heartbeat on Doppler

Cardiointervalography

This method is used very rarely and is needed only in cases where it is necessary to study the baby’s heart rhythm in detail in controversial situations or in cases of severe pathology. This technique consists of ultrasound recording of heart activity for a long time (at least 60 minutes).

This information is fed into a computer, which conducts a detailed analysis of all indicators:

The cardiointervalography method is very informative and often helps to understand true reasons heart rhythm disturbances.

Causes of fetal heart rhythm disturbances

Sometimes after a study it turns out that the heartbeat does not correspond to accepted standards. This situation must be treated with due attention and find out why this happened.

Factors leading to rapid heartbeat (tachycardia):

1. Disturbances of uteroplacental blood flow.
2. Anemia in the mother.
3. A decrease in fetal hemoglobin levels (for example, with hemolytic disease) causes acceleration of blood flow, as well as a compensatory reaction in the form of tachycardia.
4. Placental insufficiency.
5. Bleeding in the mother (for example, due to placental abruption).
6. Malformations of the heart.
7. Increased temperature in a pregnant woman (febrile state).
8. Inflammatory process in the membranes (amnionitis).
9. Taking certain medications. For example, the commonly used medicine in obstetrics, Ginipral can cause tachycardia not only in the mother, but also in the fetus. In addition, drugs that block the influence of the parasympathetic nervous system (for example, Atropine) can also cause increased heart rate.
10. Pathology of the umbilical cord (two vessels in the umbilical cord, entanglement, etc.).
11. Acute intrauterine hypoxia can cause a sharp increase in the fetal heart rate to 200-220 per minute.
12. Loss of umbilical cord loops.
13. Promotion intracranial pressure fetus

Reasons that cause a slow fetal heart rate (bradycardia):

• Prolonged stay of a woman in a supine position, in which compression of the inferior vena cava occurs.
• Taking medications that block the sympathetic nervous system, such as Propranolol.
• Severe disturbances of the acid-base balance in the fetal blood with serious metabolic disorders.
• Some anomalies in the development of the conduction system of the fetal heart.
• An increase in the concentration of potassium in the blood of the mother and child, which leads to heart rhythm disturbances and the appearance of bradycardia.
• Prolonged compression or knot of the umbilical cord.

Each of these reasons is very serious and often requires treatment, and in some cases even emergency delivery in the form of a cesarean section.

Is it possible to listen to the heartbeat at home?

Some parents wonder whether it is possible to hear the baby’s heartbeat at home, without turning to specialists, if they use a regular phonendoscope.

Of course, this method can be used. But be prepared for the fact that you will not hear a heartbeat until 21-22 weeks. In addition, you will need to be able to distinguish other sounds from the fetal heart: pulsation of the abdominal aorta of a pregnant woman, intestinal peristalsis. On average, a baby's heart beats about 1.5-2 times faster than the mother's. For convenience, you can simultaneously count the woman’s pulse while listening, so as not to confuse the rhythms of her and the baby.

Determining the sex of a child by heartbeat: myth or reality?

There is a widespread stereotype among the population that by the frequency of the heartbeat you can find out in advance who will be born: a boy or a girl. It is believed that boys' hearts beat a little slower than girls'. But can we rely on this data with confidence?

It is no secret that many factors influence the heartbeat, for example:

• Motor activity of the baby;
• Time of day (sleep or wakefulness);
• Individual characteristics of the innervation of the heart muscle and the conduction system of the heart;
• The influence of hormonal factors;
• Maternal and fetal hemoglobin levels;
• The presence or absence of certain pathological conditions during pregnancy (hypoxia, severe gestosis, bleeding, Rh conflict, etc.).

Given so many factors that change heart rate, is it possible to evaluate heart rate from only one perspective—sex determination? Certainly not. Moreover, a study was conducted in which the gender of the child was determined solely by the nature of the heartbeat, and the reliability of this technique was only 50%, which means that it is equated to the banal theory of probability: option one of two. Thus, It is not possible to find out the sex of the child only by assessing cardiac activity.

Heart rate is an indicator of many processes occurring in the fetal body. The structure of the heart rhythm contains a large amount of information.

In fact, the heart rate reflects a complex of protective and adaptive reactions of the fetus to any influences and changes. Of course, assessment of cardiac activity during prenatal period extremely important. Availability large quantity techniques, as well as their availability, greatly simplify the process of monitoring the condition of the fetus.

Despite the development of complex, invasive techniques that make it possible to thoroughly study the condition of the fetus, their danger is sometimes very high and unjustified. For these reasons everything antenatal clinics, and maternity are equipped with cardiac monitors, ultrasound machines, and all obstetricians practically do not part with a stethoscope, because this allows them to properly monitor the baby’s heartbeat without harming him.

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Methods and timing of listening to heart rate

You may ask, at what week will the doctor be able to hear your baby’s heartbeat? Approximately starting from 1-1.5 months, but only when examined using ultrasound diagnostics.

The methods the doctor will use depend on gestational age, in weeks:

• 5-6 — ultrasound using a transvaginal sensor;
• 7-8 — transabdominal ultrasound;
• auscultation or listening with an obstetric stethoscope (tube) becomes possible starting from 18-20 weeks;
• from 32-1 - we apply the CTG (cardiotocography) method.

An echoEG can be prescribed if the development of a heart defect is suspected, starting from 5 months of gestation.

Today, there are special ultrasound detectors or fetal dopplers. They can be used at home. Any mother calms down when she hears the rhythmic beating of her child’s heart. How many weeks can you use this device, you ask? Already at 12 weeks, you can regularly listen to the heart rate of the baby growing in your womb.

In late gestation future dad The baby can hear his heartbeat by placing his ear to the expectant mother's belly.

Ultrasound diagnostics

Ultrasound diagnostics is one of the first examination methods that allows one to evaluate not only cardiac activity. Using an ultrasound, the diagnostician determines the condition of the fetus as a whole, its size, and the condition of the uterus-placenta-fetus system.

Listening

Auscultation is one of the oldest methods of obtaining information about the condition of the fetus. The doctor listens:

• heart sounds;
• determines heart rate;
• rhythm;
• point of maximum audibility of the heartbeat.

The latter helps determine the position of the baby in the mother's womb. If the baby is positioned head down ( cephalic presentation), then the doctor determines the clearest pulsation on the right or left below the navel. If the child is positioned across the mother's womb ( transverse presentation) the heart is best heard at the level of the navel on the right or left side.

If the baby “sits” with his butt down ( breech presentation), then his heart is clearly audible above the level of the navel. During multiple pregnancy, the heartbeat can be heard at different points, starting from 6 months. Unfortunately, this method is sometimes not effective:

• with severe obesity in a pregnant woman;
• high or low water levels;
• when the placenta is attached to the anterior uterine wall (the noise created by the blood flow through the vessels makes it difficult to listen to the fetal heartbeat).

If there is any suspicion of fetal pathology or hypoxia, the doctor may prescribe an additional ultrasound.

This procedure is prescribed once to all pregnant women at the beginning of the 8th month of pregnancy. According to indications, it can be repeated several times. The main indications for multiple cardiotography are:

• feverish conditions of the mother during pregnancy;
• abundance or lack of amniotic fluid;
• the presence of a scar on the wall of the uterus after surgery;
• early maturation of the placenta;
• serious chronic illnesses of a pregnant woman;
• IUGR;
• late gestosis in pronounced form.

In this case, the study can be scheduled again at 37 weeks and before the expected date of birth.

EchoEG

This procedure can be prescribed at 17-28 weeks strictly according to indications. The main indications for the procedure are:

• heart defects of a pregnant woman;
• the birth of babies with myocardial defects during previous pregnancies;
• The child's ultrasound revealed a delay in development or defects in other organs;
• Mom is over 38 years old and has serious metabolic disorders.

This method allows you to study in detail the structure of the fetal myocardium and determine the characteristics of blood flow in the heart muscle.

Characteristics of heart function by week

The developing fetal myocardium does not work at the same intensity throughout the entire gestation period. Almost every week of gestation has its own norm.

The table gives an idea of ​​how the heart rate of a normally developing fetus changes.

Heart rate and gender of the child

Do you want not only to feel your child, but also to understand who you are expecting: an heir or a princess? Every mother asks the doctor at how many months can the gender of the child be determined. A good ultrasound diagnostician will tell you who you are carrying already at 4 months. But sometimes the child “hides”, does not allow him to see his genitals, and only when he is born will his parents find out who they brought into this world.

You, of course, know the myth that the sex of a child can be determined by the beating of its heart from the very first weeks of gestation? There is no medical confirmation of this. Perhaps there are specialists who know pulse diagnostic methods and can give you an accurate answer, but official science does not have such methods.

Unofficially, it is believed that if you have a boy, his pulse from 14 weeks will be about 148 beats per minute, slow and clear. The girls' hearts skip a beat. You can try to determine the baby's gender using this method. But this determination of gender gives the correct result with a probability of 50%.

On this note, we bid you farewell until further articles. Visit us again and share information with your friends via social networks.

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Introduction

For every woman preparing to experience the joys of motherhood, the most pleasant and long-awaited sound is the heartbeat of an unborn child. It symbolizes the beginning of a new life and the moments of joy and happiness associated with it.

The heartbeat of a pregnant fetus serves as an important indicator by which a specialist determines such vital factors as blood oxygen saturation, hemoglobin content, features of the anatomical structure of a small heart, hormonal functions and features of the autonomic nervous system.

Analysis of the fetal heartbeat is carried out using various methods, including an obstetric stethoscope, cardiotocography, and ultrasound.

Regular monitoring of the baby’s heartbeat in the womb is one of the determining factors in the management of pregnancy and childbirth, making responsible decisions that allow saving the baby’s life in emergency cases.

When does fetal heartbeat occur?

Already during the 2-3 week period of a child’s development, his heart is formed in the mother’s womb. At this stage, a woman may not even suspect that she is pregnant.. The formation of the heart begins with its appearance in the form of a simple tube, which after a couple of weeks acquires an S-shaped bend. For this reason, this period in the development of the heart is called sigmoid.

After 4-5 weeks, the primary septum appears, separating the atria, which leads to the appearance of three chambers in the structure of the small heart. From this moment its first contractions begin. Listening to a knock can only be done using an expert-class ultrasound machine. If there are no special indications for such early listening, it should not be used.

During weeks 5-7 of embryo development, an indirect indicator is used to determine the nature of embryo development - the level of the hormone hCG (chorionic gonadotropin).

For measurements, data are taken over time after 2-3 days. Normally, by week 5, the content of this hormone should fluctuate between 1000-3100 mIU/ml. If pregnancy develops normally in the early stages, then the level of this hormone will double every 2-3 days, then its low

Experts believe that analysis for this hormone can be reliable only up to the 10th week of pregnancy. At later stages, it begins to fall, and its low content during this period corresponds to the physiological norm. This diagnostic method serves as an alternative to ultrasound at the very beginning of pregnancy.

One of the fundamental characteristics during pregnancy, indicating its proper course, is the fetal heartbeat. One of the first methods used to study it by obstetricians is auscultation. It is a physical diagnostic method that allows you to determine the condition of an organ by listening to the sounds it makes.

Typically, the fetal heart is listened to using this method no earlier than 18-20 weeks of gestation. Until this time, the heartbeat is usually weak; in the early stages, for this reason, it is very difficult to hear without the use of special methods.

Fetal heart rate

Throughout pregnancy, the heart rate changes depending on the activity of the heart and the period of development:

• On 6-8 weeks it is not below 110-130 beats per minute;
• On 9-10 weeks– 170-190 beats/min.;
• Beginning from 11th and more later weeks until childbirth it is in the range of 140-160 beats/min.

Such changes are explained by the continuous development of the fetus, during which the functioning of the autonomic nervous system, responsible for the coherence of the work of all internal organs and systems, takes place.

For diagnostic accuracy, doctors use special tables that allow them to monitor whether the development of the heartbeat corresponds to physiological norms. What the heart rate should be at different stages of pregnancy can be found in Table 1.

Table 1. Physiological norms for the period of embryonic development and heart rate

Purpose of fetal heartbeat detection

Listening to a baby's heart rate before birth is done for several reasons:

Methods for diagnosing fetal heartbeat

The main methods for diagnosing the heartbeat of an intrauterine child are:

• Ultrasonography;
• Auscultation;
• Cardiotocography (CTG);
• Echocardiography.

Ultrasound is the very first method used to study the condition of the embryo.

Using this method we study:

• Heart rate;
• Fruit size;
• Condition of the placenta;
• Heart sounds;
• Structure of the heart;
• Possible defects, as well as other anomalies, if there are reasons for their occurrence.

Features of ultrasound are shown in Table 2.

Table 2. Ultrasound technique at different stages of pregnancy

The auscultation technique involves listening to the following signs:

• Heart rate;
• Clarity of tones;
• A place to listen to them in the best possible way.

The advantage of this method is that it can be used by a person without special education. Using a medical tube, you can easily hear heart sounds and count their number per minute using a stopwatch.

It is important to understand what heart sounds are and their significance as an indicator of fetal development. The normal development of the child's body should be accompanied by clear and distinct sounds of the heartbeat.

If the tones become dull, then this may be a sign of acute and chronic hypoxia.

In rare cases, poor listening tone occurs, which is a sign of the need for additional examination methods.

Other methods are also prescribed if:

• There are changes in the volume of amniotic fluid (increased or decreased);
• In case of multiple pregnancy;
• The woman is overweight and the thickness of the subcutaneous fat cell of the anterior peritoneum does not allow the use of auscultation;
• The placenta is located at the anterior wall.

The cardiotocography method is very informative for assessing the quality of the heartbeat. When used in the early stages, it is possible to detect the presence of oxygen starvation in the baby so that the necessary measures can be taken. It is usually prescribed after the 32nd week and before birth.

The machine used in this procedure is an ultrasonic transducer. The signals sent from it are reflected from the heart of the embryo. The changes that occur are recorded on a special film.

Typically, in addition to the main sensor, the doctor uses a contraction sensor in the uterus, which makes it possible to measure its activity, which is of particular importance during childbirth. Modern devices also have special sensors that record fetal movements, which a woman can even do independently. The received information is also displayed on the tape.

Recording using this method is carried out with the woman lying on her back. Due to the fact that in the later stages this causes great inconvenience, it may be recommended to take a sitting or lying position on your side.

For this purpose, the sensor is installed on the stomach, where the point of best listening to tones must first be found. The entire procedure is carried out in 40-60 minutes. In some cases, the sensor can be left for a day.

The following indicators are assessed using this method:

1. Fetal heartbeat and characteristic changes that occur during contractions in the uterus.
2. Heart rate.
3. The dynamics of heart contractions (that there are no violations will be indicated by changes in the number of beats within 25 per minute).
4. The appearance of a rapid rhythm in response to contractions in the uterus, which should not occur normally.
5. The appearance of rarer contractions is taken as normal in the pelvic position of the fetus, but may also indicate acute or chronic hypoxia in other cases.

During pregnancy, CTG is prescribed to each woman at least once.

According to the standards for this method, which establish how the heart should beat, doctors believe that 120-160 beats should be recorded per minute.

There are a number of indications for repeated mandatory use of this method:

1. Late gestosis.
2. The presence of a scar on the uterus due to surgery.
3. Changes in the volume of amniotic fluid.
4. Previous infectious pathologies in which a high temperature was observed.
5. Chronic maternal illnesses (diabetes mellitus, arterial hypertension).
6. Premature aging of the placenta.

If a detailed study of the structure of the fetal heart and the characteristics of blood flow in its different parts is necessary, echocardiography is prescribed if indicated. It is usually carried out at 18-28 weeks.

Indications for its implementation may be the following:

1. Existing congenital heart defects in a woman.
2. Birth of previous children with congenital defects.
3. When a woman is over 38 years old.
4. Infections during pregnancy.
5. Presence of diabetes mellitus.
6. Observed delays in intrauterine development of the embryo.
7. Suspicion of the presence of defects in the fetus of both the heart and other organs, which may be combined with disturbances in the development of the heart.

Fetal Doppler is also used as a technique for studying the heartbeat. This is a portable device that you can use at home yourself. The principle of its operation is similar to CTG, but without recording on film. It comes with headphones, allowing you to listen comfortably at home.

You can hear the baby’s heartbeat as early as 8 weeks, but experts recommend using it later, after 12 weeks, if necessary. The duration of the study should not exceed 10 minutes.

Table 3. Pros and cons of portable Doppler

Is it possible to determine the sex of a child by heart rhythm?

In order to determine the sex of the unborn child, there are a number of traditional methods, which in most cases are rejected by doctors.

Palpitation is an important sign according to traditional medicine in this matter:

1. Listening to the heart rhythm by week You can determine whether a boy or a girl will be born, depending on the clarity and rhythm. Usually this is how a boy’s heart beats, while girls’ hearts beat more chaotically, not coinciding with their mother’s.
2. According to the location of the heart A little to the left predicts the birth of a girl, and to the right - a boy.
3. Because, How many heart beats happens in a minute, you can determine the gender of the unborn child:

Table 4. Number of heart beats in embryos of different sexes