Fetal Heart Rate and Defects

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Electronic fetal heart monitoring is commonly used for tracking how well the baby is doing within the contracting uterus and for detecting signs of fetal distress. External fetal heart monitoring is performed by attaching external transducers to the mother's abdomen with elastic straps. The transducers use Doppler ultrasound to detect fetal heart motion, and the information is sent to the fetal heart monitor which calculates and records the fetal heart rate on a continuous strip of paper. More modern fetal heart monitors have incorporated microprocessors and mathematical procedures to improve the fetal heart rate signal and the accuracy of the recording. An echocardiography can be used before birth to accurately identify many heart defects. The mother can be treated with medications that may restore normal heart rhythm in the fetus if the test shows that a fetus’s heart is beating too fast or too slow (Emitting & Waves, R.C., n.d.). The fetal heart starts as a tube which folds and fuses in a complex structure that results in a muscular pump with four chambers and four valves. It is not surprising that small errors in development can lead to a wide variety of structural abnormalities in the 4 chambers, the 4 heart valves, the veins and great arteries. During fetal monitoring, a nurse will evaluate the strip for continuity and adequacy for interpretation, identify the baseline fetal heart rate and presence of variability, determine whether there are accelerations or decelerations from the baseline, identify patterns of uterine contraction, and correlate accelerations and decelerations with the uterine contractions. This will allow the nurse to determine whether the fetal heart rate recording is reassuring, non-reassuring, or ominous (Children's Heart Federation, n.d).

Fetal Heart Rate and Defects
The normal fetal heart rate is between 110 to 180 beats per minutes (BPM), but can vary. Fluctuations of the fetal heart rate (usually associated with fetal movement) during different periods of the day are common and often rise above 160, going as high as 180 to 190 and are considered normal. Listening to a normally beating heart using a fetal ultrasound Doppler as early as 8 weeks can offer reassurance and cut down on a lot of stress and help assure that the developing fetus is healthy. While miscarriage occurs in only about 15 percent of apparently normal pregnancies, it only occurs in about 1 percent of pregnancies where a normal heartbeat has been seen or heard (Medscape, n.d). Recent studies conclude that changes in pregnant women's heart rate and blood pressure due to chronic stress and anxiety can have an effect on the fetal heart rate. The study did not report any negative effects on fetal health but confirmed that emotional based changes in a woman's cardiovascular activity can have "real-time effects” on a fetus. A previous study has shown that stress during pregnancy can cause an increase in the risk of low-birth weight and premature birth. More importantly, increased evidence suggests that pregnancy stress can actually affect the baby's behavior and functioning later in life (NT: Detection Rate CHD, n.d.). The ability for expectant mothers to listen to the fetal heart rate with a fetal Doppler offers a safe method of early fetal bonding which was previously only available at prenatal appointments with a medical professional. With its approval for in home by the FDA expecting parents have increasingly been opting to rent or purchase fetal Dopplers to help relieve some of the stress associated with the unknowns of early and late pregnancy. Fetal Doppler rentals are currently available through many online retailers at very affordable rates.

Fetal heart rate monitoring is the process of checking the condition of a baby during labor and delivery by monitoring his or her heart rate with special equipment. Electronic fetal heart rate monitoring (EFM) was first introduced at Yale University in 1958. Since...
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