Fetal bradycardia, a slow heart rate in a fetus, can be caused by medications taken during labor, low maternal blood pressure, and umbilical cord compression. It can be detected and monitored with fetal heart monitors and treated with drugs or addressing underlying medical conditions. Congenital conditions can also cause fetal bradycardia and can be detected with an echocardiogram.
Fetal bradycardia refers to an abnormally slow heart rate in a fetus and is usually temporary. Symptoms include a fetal heart rate below 110 and slow fetal movement. One of the main causes of this condition is the medications taken during labor by the mother. These medications include narcotic pain relievers, synthetic hormones, and drugs that are injected into the epidural space of the spinal cord for pain relief.
Other causes of fetal bradycardia include low maternal blood pressure and umbilical cord compression. When the fetus doesn’t get enough oxygen, it can cause fetal distress, leading to fetal bradycardia. When the mother lies on her back, pressure is placed on a large blood vessel known as the superior vena cava. This can cut off fetal oxygen and result in a low heart rate. Many healthcare professionals recommend that pregnant women avoid lying on their backs and advise lying on their left as they approach the second trimester of pregnancy.
Sometimes umbilical compression and fetal bradycardia can become severe and even life-threatening. In these cases, an emergency caesarean section may be indicated to restore oxygen to the baby and increase the heart rate. Fetal heart rate monitoring is typically done with an internal or external fetal heart monitor. These monitors are routinely applied once the patient goes into labor and are capable of detecting even the subtlest cardiac deviations.
When maternal narcotics are the cause of fetal bradycardia, certain drugs can be given to the mother to counteract the effects. These drugs often work quickly to normalize the fetal heart rate, but can sometimes cause side effects. Other causes of fetal bradycardia can include maternal medical conditions such as lupus. This autoimmune condition can cause cardiac arrhythmias in the fetus and mother. Treating the underlying condition in the mother can often relieve the arrhythmia in the fetus.
Congenital conditions can also cause a slow heart rate in the developing fetus. These include structural abnormalities and can often be detected by a medical diagnostic test known as an echocardiogram. This test uses sound waves, or ultrasounds, to take pictures of the heart in real time. A health care provider can determine if the heart is structurally sound by examining the chambers and valves, and can also determine if the heart is contracting adequately to promote optimal circulation. Abnormal rhythms such as bradycardia and tachycardia, which is an abnormally high heart rate, can also be determined.
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