ECG of pregnant women with suspected heart disease: is the procedure harmful for the baby? ECG during pregnancy: deciphering the indicators

An ECG during pregnancy is done to assess the work of the heart. For women in position, the issue is especially relevant - it is no secret that due to the increased volume of circulating blood, the load on the body increases significantly. In order to avoid pathologies of fetal development, it is necessary to carry out ECG procedure even before conception or at the beginning of the term. If abnormalities are detected during the examination, the woman will need to be observed by a cardiologist.

Preparing for an ECG

One of the advantages of the procedure is that it does not require special preparation. Electrocardiography is undesirable to do on an empty stomach or immediately after eating. Therefore, it is better to eat 2 hours before the examination. Before the ECG, you need to relax, take a break for about 10 minutes. This is necessary in order for the heart rate to stabilize. This concludes the recommendations before the procedure.

Indications for ECG during pregnancy

Electrocardiography for pregnant women is indicated in the following cases:

With complications during childbearing.
When registering a pregnant woman.
In the presence of pain and a feeling of heaviness in the chest, especially in the region of the heart.
When changes occur in a pregnant woman blood pressure(especially if there are frequent dizziness, fainting, headaches).

There are no contraindications for electrocardiography.

How is it carried out?

One of the most important procedures during pregnancy is the ECG. Where can I get a quality check? Feedback on this issue will help medical institutions your city.

The examination process is absolutely harmless and painless. In view of this, there are no contraindications. An ECG is a mandatory measure when registering a pregnant woman, regardless of complaints and a predisposition to disorders in the work of the heart.

The patient lies down on the couch. At the same time, the places where the sensors will be installed must be bare. For better contact electrode paste is used with the skin. The data recording process takes no more than 5 minutes. During the study, the machine reads the electrical impulse from the heart and records it as a graph on paper tape. Then the cardiologist issues an ECG conclusion.

Indications

On early dates pregnancy, the device usually shows an increase in the length of the P-Q and Q-T intervals. But their data in the absence of pathologies are within the normal range. Over time, these deviations are eliminated.

During childbirth, especially in the process of contractions and attempts, there is a decrease in the QRS value, the width of the P wave and the length P-Q interval. In addition to such a violation, sinus bradycardia, sinoauricular blockade and coronary sinus syndrome may develop. If a woman does not have heart disease, the indicators should return to normal within a few days after giving birth.

Decryption

The results are evaluated by the nature of the heart rhythm and its frequency. These data are obtained during the ECG process. Decoding allows for single extrasystoles, which do not occur in the sinus node, but in another part of the heart muscle. The electrical impulse may take place in the atrioventricular node of the ventricles or in the atrium. This rhythm is called ventricular or atrial, respectively. Similar state requires special attention, diagnosis and treatment.

A heart rate (HR) less than 60 beats per minute is called bradycardia. If the heart rate is more than 90 beats per minute, tachycardia is diagnosed. It may occur in healthy person during emotional and physical stress.

The electrical axis of the heart (EOS) must coincide with the anatomical axis. It characterizes the position of the organ in the chest. Normal performance EOS - 30-70 degrees. During pregnancy, a value of 70-90 degrees is allowed. It is not considered a deviation and should return to normal soon after delivery.

Detect heart problems early stage EKG will help. Data decryption does not take much time, so the result can be found out on the same day.

What is CTG?

Cardiotocography (CTG) is a very simple and common technique for recording data about the health of an unborn child. The apparatus through which the procedure is carried out is relatively inexpensive, therefore it is often located in the office of a gynecologist-obstetrician.

The fetal ECG during pregnancy is called cardiotocography. It is harmless to the unborn child. Scientific works that disprove this fact does not exist. However, in some cases, women notice oddities in the behavior of the baby - he may become restless or calm down too much. This is due to the fact that the operation of the device is accompanied by sound vibrations that are unusual for the fetus, and also to the fact that the sensor that records the readings is installed quite tightly.

The equipment intended for carrying out CTG is of several varieties:

Devices that record the fetal heartbeat on paper tape without deciphering the results. The resulting tape is analyzed by a cardiologist.
Devices that record and then decode CTG themselves.

Features of the

CTG (unlike ECG) during pregnancy is not allowed for all women:

The term must be at least 30 weeks. At earlier dates it is impossible to decrypt the received record.
The procedure takes 10 minutes, sometimes longer. A shorter length of time may not give accurate results.
As in the case of an ECG, a pregnant woman should not eat heavily before the study, and she also needs to rest.
The procedure can not be carried out at a time when the child is sleeping.
To improve conductivity, sensors connected to a woman's body are treated with a special gel.
Only a specialist doctor should decipher the results.

In what cases is CTG performed?

Cardiotocography is used for early diagnosis fetal pathologies. Indications for conducting CTG can serve:

CTG and ECG - during pregnancy very important procedures. It is on the basis of these studies that the further course of the process of bearing a child is predicted.

An ECG during pregnancy is performed to monitor the functioning of the heart, because at the stage of bearing a baby, the load on the woman's body increases. In addition, it appears extra circle circulation to ensure prenatal development useful substances, which leads to more work of the heart muscle.

Is it possible to do an ECG during pregnancy?

An ECG during pregnancy is a diagnostic procedure that allows you to study the activity of the heart in dynamics. In medicine, using an electrocardiograph, you can get information on the speed of the impulse, the frequency and rhythm of the heartbeat, while the data are recorded on paper.

The need to do an ECG during pregnancy is prescribed in the mandatory diagnostic procedures, which is carried out 1 time for the entire 9-month period. The electrocardiograph does not carry any load, only heart rates are taken and recorded using special sensors.

It is not uncommon for women to have a question: how often can an EKG be done during pregnancy? Since the electrocardiogram is absolutely safe, there are no restrictions on the number of procedures. Diagnosis is required to determine how well the heart muscle copes with the increased load in the early stages, as well as an ECG is performed for medical examination during pregnancy.

How is an ecg done for pregnant women?

An ECG is done for pregnant women at the first visit, when a referral for examination is issued, for a period of 32 weeks or if there are indications:

having shortness of breath or heart palpitations;
pain syndrome slightly to the left of the middle of the chest;
sudden jumps in blood pressure;
the appearance of dizziness, up to fainting;
any complications associated with the gestation period.

The ECG procedure is performed by a cardiologist who monitors the indications and, if necessary, deciphers the results. An electrocardiogram is done lying down, at rest, it is better to eat a meal a few hours before the examination, so as not to distort the effectiveness. Not infrequently, pregnant women are given a few minutes to calm down, as unnecessary emotional experiences negatively impact performance.

Electrode sensors are installed on the shins and wrists; before that, the attachment point is wiped with alcohol for better impulse transmission. The procedure for fixing the data itself lasts about 10-15 minutes. During this time, the specialist receives a paper version, which shows 12 graphs of cardiac electrical impulses.

Norms and interpretation of ECG during pregnancy

The main ECG parameter is changes in the rhythm of the heartbeat (HR), the norm, which ranges from 60 to 80 beats per minute. It can be diagnosed as bradycardia, when the heart rate is lowered, or tachycardia, with elevated rates.

It must be understood that the ECG norm during pregnancy has slight differences from the parameters of non-pregnant women. So, the dome of the diaphragm, as the fetus grows and the uterine cavity increases, leads to the rotation of the heart around its sagittal axis. There are other indicators that change somewhat during fetal development:

A rapid heartbeat up to 90 or 100 beats / min is considered normal if a shortening of the RR interval is observed on the transcript. The causes of this condition are increased blood volume and reduced vascular tone due to the production of hormones during pregnancy.
Respiratory arrhythmia is manifested on the cardiogram by an extended RR interval on inspiration. If the patient has vegetative-vascular insufficiency, then this can be considered a variant of the norm.
Violation in ventricular conduction during pregnancy is often considered a normal single manifestation if a woman does not complain of pain, and there is no history of heart pathology.
Shortening of the pq interval in the absence of symptoms is regarded as an option normal state. Basically shortened pq and bad ecg when appear in stressful situations when a woman is emotionally overstrained.

It should be noted that often in pregnant women there is a violation of the process of repolarization of the ventricular myocardium, in this case a detailed interpretation of the ECG by a cardiologist will be required and it may be necessary to make a repeated cardiogram on later dates gestation.

An ECG during pregnancy is indicated as a mandatory screening examination. Describe state of cardio-vascular system during this period can be especially difficult, since significant hemodynamic changes that occur during normal pregnancy tend to cause signs and symptoms that mimic cardiovascular disorders.

Shortness of breath, fatigue, palpitations and chest discomfort are common complaints in pregnant women. Even in the early stages, cardiac output increases, peripheral edema occurs, and pulsation of the jugular vein is noticeable. ECG during pregnancy will help to distinguish real problems with a heart from other diseases, causing pain in the chest. For example, spasm of the intercostal muscles, spasm of the esophagus and gastroesophageal reflux, gastritis, pneumonia, tracheobronchitis, panic attack and the like.

Electrocardiography is safe during pregnancy, unlike, for example, an X-ray examination, which is why it is so widely used in obstetric practice in conjunction with a Doppler study of blood flow through the coronary vessels and an assessment of the overall functionality of the heart.

Features of the cardiogram of pregnant women

Changes in the cardiogram of pregnant women are associated with an anatomical shift in the position of the heart. The growing uterus supports the diaphragm and organs of the chest, the spatial vectors of the heart change, which are displayed on the cardiogram by segments QRS, ST, P. Often the decoding of such a graph in pregnant women with normal heart determines sinus tachycardia and deviation of the electrical axis both to the right and to the left. There is also depression of the ST segment, smoothing of the T wave, in the later stages a pathological Q wave appears, but clinical significance these changes do not.

There is also an increase in the mass of the myocardium and the size of the left ventricle in pregnant women by 30% above the norm. In addition, in the first two trimesters, the diastolic function (relaxation) of the left ventricle increases, and in last trimester decreases.

However, hormonal changes accompanying pregnancy, increase the excitability of the myocardium and its sensitivity to the action of hormones acting through adrenergic receptors.

Procedure

ECG for pregnant women is carried out according to the same method as in normal cases. An important role is played by the environment that creates a common positive attitude and a sense of comfort. Expectant mother is offered to rent outerwear, exposing chest, also release the ankles and wrists. Sensors will be installed on these areas - electrodes on suction cups or in the form of terminals or plates. The nurse will first degrease the skin, and then either put wet tissue pads under the electrodes or lubricate them with a special electrode gel. During the procedure, the cardiograph will record on the tape the impulses received from 12 sensors. The nurse, by switching the toggle switch, will change the recording channels, and may also ask you to hold your breath literally for 30–40 seconds.

For pregnant women, the usual ECG technique is used.

All this is necessary to fully determine the performance of the heart:

Rhythm and its source. Normally, this is a sinus rhythm, that is, initially the sinus-atrial node gives an impulse to excite the myocardium. An electrocardiogram can record a normal rhythm, rapid, slow, or uneven. These conditions are appropriately named - tachycardia, bradycardia, arrhythmia. The heart rate is normally 60-80 beats per minute, but in pregnant women it is physiological and some increase - up to 90 beats per minute. Violation of the formation of an impulse also includes extrasystoles (extraordinary contraction) of various nature - atrial, atrioventricular, ventricular.
Electrical axis of the heart. If in the normal state this indicator is in the range of 30-70 0 C, then in pregnant women, when the uterus supports the heart, it approaches 90 0C. After delivery, this indicator returns to normal.
Excitation speed. If somewhere in the heart muscle there is pathological changes, then the speed of impulse conduction is violated. This is how they define different kinds heart blockades - in the atrium, in the legs of the Hiss bundle, in the antroventricular node.

Possible causes of cardiac dysfunction in pregnant women

Functional changes associated with hormonal changes in the body and general mental state in a pregnant woman.
Deterioration of the manifestations of an existing disease - coronary heart disease, myocarditis, pericarditis, cardiopathy, malformations, tumors in the heart.
Disease of the central nervous system, which has an expression in the form of psychogenic arrhythmia.
Endocrine disorders - for example, thyrotoxicosis.
Electrolyte imbalance - hypokalemia and magnesium, hypercalcemia.
Hereditary cardiac diseases, such as cardiomyopathy, premature ventricular excitation syndromes, weakness of the sinus node.

A bad cardiogram against the background of existing diseases is a reason for a pregnant woman to contact a cardiologist

It becomes clear why an ECG is done for pregnant women. At the beginning of pregnancy, when registering, in order to provide timely assistance to the expectant mother in bearing the fetus, if there are heart problems. During gestation, to monitor changes in maternal health and developing child, control over possible preeclampsia or the development of heart failure.

Fetal ECG

In addition to monitoring the health of the mother, electrocardiography allows you to determine the cardiac activity of the fetus.

Maternal ECG (A), Fetal FCG (B), Fetal ECG (abdominal lead) (C); I and II - fetal heart sounds

The procedure can also be performed at 15 weeks, but it is most advisable to do a fetal ECG after the 34th week. The electrodes can be placed on the mother's abdomen or inserted between the wall of the uterus and the back of the fetus (much less frequently performed).

The indicators recorded by the ECG are standard: heart rate, rhythm, shape, size and duration of the ventricular QRS complex.

Another option for studying cardiac activity in utero is phonocardiography (FCG), which is carried out by recording sound signals at the points where it is best heard. FCG captures the first and second heart sounds.

Of great diagnostic importance in the examination of a pregnant woman in the later stages is the complex use of ECG and FCG methods - phono-electrocardiography

Never refuse an EKG. This examination method is safe and very informative. It helps to identify abnormalities in the work of the heart long before the onset of symptoms.

A pregnant woman is forced to undergo a large number of clinical research to keep abreast of how the baby feels in the womb. These studies are of no small importance for monitoring the health of the expectant mother, because it is on this that the well-being of the fetus and the favorable course of pregnancy will largely depend. In this article, we will look at such an important clinical study as the ECG during pregnancy.

The volume of blood circulating in the body of a pregnant woman is significantly exceeded. Because of this, her heart works with increased stress. In addition, hormones also affect its functioning, the level of which also increases during the period of bearing a child in a woman. For these reasons, every woman in the earliest stages of pregnancy should have an ECG. As a rule, doctors prescribe this procedure for expectant mothers when registering, but it is not mandatory. It becomes extremely necessary if a woman is in a position:

faces constant pressure surges;
she has pains in the heart area, or she feels some kind of heaviness;
often headache and dizziness, fainting occurs;
there are problems that complicate the course of pregnancy ( we are talking about polyhydramnios or oligohydramnios, gestosis).

Some expectant mothers are very worried about whether an ECG is possible during pregnancy, because there is an opinion about this procedure that it can somehow negatively affect the health of a child or woman. All this is a myth, since the ECG is the safest and most painless medical manipulation. It allows you to register the human electric field, heart rate and pulse, it does not have any effect on organs and tissues, so do not believe those who claim that ECG during pregnancy is harmful, there are no contraindications to this manipulation in principle. On the contrary, try to have this procedure done by your local GP, unless your gynecologist immediately prescribes it for you.

ECG during pregnancy: how is this procedure done?

An ECG of the heart during pregnancy is a common procedure that does not require special preparation from a woman. However, there are still several simple recommendations, which expectant mothers are better off sticking to before going for an ECG during pregnancy:

On the eve of the procedure, it is better not to overwork physically, but to have a good rest. If you feel tired, then this may distort the results, they cannot be considered reliable.
You should also not overeat before an ECG, but this manipulation should not be performed on an empty stomach, since in both cases the results will not be plausible.
put on comfortable clothes so that you can easily expose the places where the electrodes (heart area) and plates (wrists and shins) are attached.

The woman will need to lie on the couch on her back. Therefore, warn the doctor in advance if in this position you may become ill due to compression of the vena cava. In fact, the procedure does not last long, but anything can happen. In order to prevent an attack, be sure to empty bladder so that it does not put additional pressure on the vena cava.

ECG during pregnancy: interpretation of the result

We offer to figure out exactly what parameters are recorded by the electrocardiogram:

First of all, the heart rate and its nature are recorded. Normally, the ECG during pregnancy should have a sinus heart rate, and the beat rate should not exceed or be less than 60-80 beats per minute. Other indicators indicate deviations:

if the frequency of strokes is less than 60, then the woman most likely develops bradycardia;
if more than 90, then she will be diagnosed with tachycardia.

If during pregnancy the ECG showed changes in the work of the heart muscle, this may be the norm. It is permissible if separate extrasystoles. But if an atrial or ventricular rhythm is heard, then additional diagnostics and the selection of the correct treatment are necessary.
The electrical and anatomical axes of the heart during pregnancy may not coincide. The heart may shift slightly while a woman is carrying a child, and after childbirth return to its original position.
If any blockades form on the teeth or segments of the cardiogram, then we can talk about the presence of a pathology that must be treated during the period of bearing a child, or at least monitor how it develops.

If a woman has a bad ECG during pregnancy, then she will definitely be sent for hospitalization in cardiology, where she will have to undergo complex treatment. In some cases, it is even necessary to terminate the pregnancy, because there is a danger to the life of the mother during childbirth.

fetal ecg during pregnancy

An ECG of a child during pregnancy is practically not prescribed today, since the health of the baby's heart can be assessed by ultrasound. This method can be resorted to if during ultrasound abnormalities in the functioning of the fetal heart were identified, which need to be monitored in dynamics.

Deciphering the fetal ECG during pregnancy includes a description of such fixed parameters:

Frequency and rhythm of heart contractions. Normally, the fetus should have at least 110 and no more than 160 beats per minute.
Fetal movements. A woman needs to press a special button at the moment when she feels the push of the child. Normally, these shocks should not be more than 2. On the cardiogram, these shocks will appear as one big wave.

The resulting indicators correspond to a certain distribution, according to which it is possible to diagnose the fetus:

If the child is all right, then the doctor will put his well-being 8-10 points.
If the condition of the baby according to the cardiogram is disappointing, then the doctor will put 6-7 points and prescribe a second examination. Do not be upset about this, sometimes the moment of the ECG simply does not correspond to the wakefulness of the child. The weather can also affect the results.
If the child's condition is big problems, then the doctor puts 1-5 points and urgently sends future mother for hospitalization.

Almost all women who monitor their health and well-being of the fetus, in without fail do an EKG during pregnancy. Do not miss an extra opportunity to control the situation, because the life and health of the baby depends on your vigilance.