Advice 1: How to listen to a fetal heartbeat

During pregnancy it is important to have information about the heart rate of the fetus. It depends on the health of the heart and other organs. By inspection it is possible to identify any violation and proactively resolve the cause, then the child was born healthy. There are ways that can be heard a fetal heartbeat. based on the results it is possible to do certain conclusions.
The listening to the heart with the help of cardiotocography
Every pregnant woman wants to hear the sound of the heart of their unborn child. Because the fetal heartbeat is considered a major sign of the vitality of the embryo. If the heart rhythm is correct, it's safe to say that the child is healthy and has no abnormalities. If the fetus ' heart completely stops beating, it generally indicates either a miscarriage or intrauterine asphyxia and other anomalies. Therefore, an important part of pregnancy is listen to the heartbeat and movements of the fetus. For monitoring cardiac activity of the child used ultrasound (ultrasound), Echocardiography (echocardiography), auscultation (listening with a stethoscope, cardiotocography.
Already the fourth week of pregnancy the embryo begins to develop the heart. At first it is a hollow tube, and then, closer to 6-8 weeks of pregnancy, it becomes similar in shape to the adult heart. During this period the heart begins to perform its functions, and the embryo receives nutrients through the primary blood vessels. Closer to the third month of pregnancy the placenta is formed, through which the exchange of nutrients between mother and child comes the so-called placental period, which lasts until the onset of childbirth.
In the first weeks of pregnancy monitoring cardiac activity of the embryo can be carried out only with the help of ultrasound. In the first 5 - 8 weeks the fetal heartbeat is 110-140 beats / minute, and further, since the second trimester, the heart rate accelerated to 160 beats per minute. Output heart rate outside this range indicates the presence of pathology. When heart sounds are not listened at all, it says that the pregnancy is not growing, or there is a failed miscarriage.
The pregnancy and external factors (heat, cold) have a great influence on the heart rate of the fetus. Diseases of the mother and her lifestyle also play a crucial role in the life of an embryo. Often the rhythm slows down due to a variety of heart defects of the fetus. This is especially noticeable in late pregnancy. If there is suspicion of a malformation of the heart of the embryo, the gynecologist sends a pregnant woman into a more detailed examination by echocardiography and cardiotocography.
Auscultation (listening to fetal heart), unlike ultrasound, is performed later in pregnancy. For this fetal stethoscope is used, differing from ordinary fact that it has a wide bell. This stethoscope to listen not only heart sounds of the fetus, but the child's movements and sounds created by the body most pregnant women: uterine murmur, heart rate, bowel function, breathing.
Through auscultation, it is also possible to draw a conclusion about the presence in the child's development of certain pathologies and to detect multiple pregnancies, determine the position of the fetus in the uterus, depending on which is changing the place where the heart sounds are listened in the best way. If the baby is head down, heart tones are best auscultated below the umbilicus. In case, if the fetus is breech, the heartbeat can be heard at or above the navel. In addition, if the child's head is flattened, and the breast pressed to the wall of the uterus, the heart can be heard more clearly than in the flexed position of the fetus, when the child touches the back wall of the uterus.
Auscultation as ultrasound helps to monitor the pregnancy and identify any defects and diseases of the fetus. It also defines indicators of the progress of the pregnancy, possible risks to the mother. In the parameters auscultation gynecologist can conclude how beneficial is pregnancy, and, in the case of any violation, to promptly eliminate it.

Advice 2: How to determine the fetal heart rate

For every future mother is very important to hear the beating of her heart unborn crumbs. To determine the fetal heart rate was possible due to several methods, for example by means of conventional obstetric stethoscope, ultrasound machine, and for performing echocardiography of the fetus.
How to determine the fetal heart rate
The easiest way to hear a fetal heartbeat with the help of medical stethoscope. Attach the diaphragm of the stethoscope to the abdomen, a flexible tube insert in the ears. With this device you can hear other sounds of the female body. However, to distinguish the baby's heartbeat in the womb, according to his rhythm – he's about two times faster than women. To hear using stethoscope heart rate is possible only to the 16 – 17th week of pregnancy. You can distinguish the sounds of the beating of a heart, applying his ear to the woman's stomach, but it depends on the position of the fetus against the uterine wall.
Listen to the baby's heartbeat by ultrasound, which can distinguish the pulsation of the cardiac muscle of a fetus for 3 or 4 weeks pregnant. With the help of ultrasound machine can also monitor the correct development of the heart and blood vessels of the fetus. This method allows to identify possible deviations and provide timely medical assistance.
A fetal heartbeat can be heard on echocardiography. This method is an ultrasound examination of the fetus, a bit different from the usual that all the attention is paid exclusively to the heart. Echocardiography allows to investigate the function of the fetal heart in two modes. A one-dimensional mode is applied to study only the cardiovascular system, and Doppler is intended for research and analysis of blood flow in different cardiac departments. Echocardiography helps the specialist in the study of the structure and function of the heart and adjacent large blood vessels and can be performed solely on the testimony of doctors – cardiologists.
One of the most effective methods for listening to the heartbeat of the fetus is cardiotocography. It is a simultaneous registration of fetal heart rate and uterine contractions in childbirth. Cardiotocography has been widely used in the late last century and has provided physicians with the possibility of more careful monitoring in the delivery period for the fetus. In the period of fights the cuts affected not only the uterus, but the whole abdominal cavity. This affects primarily on the supply of oxygen to the baby. CTG also gives the opportunity to determine the motor activity of the fetus.

Advice 3: Transverse fetal presentation: features and precautions

In the final stages of pregnancy, the doctor may determine fetal presentation. The position of the presentation of the fetus is determined by the position of the child's body, turned to the exit of the birth canal.
Transverse fetal presentation: features and precautions
The following types of presentation: transverse, pelvic, head and oblique. Transverse and oblique position is always resolved by caesarean section, at the head position of the fetus during childbirth in a natural way, breech is also recommended to carry out the operation.

Determination of the form of presentation of the fetus is diagnosed when the conduct: ultrasound, three-dimensional ultrasound, vaginal or obstetric study. Are these procedures before birth in the maternity ward. The most accurate is the diagnosis of the presentation of the fetus, performed after 35 weeks of pregnancy. But after 36 weeks a baby in the womb usually takes the position in which to be born.

Determination of the position of the fetus is very important when monitoring the progress of pregnancy, which is necessary to determine how the delivery and tokie to prevent possible complications during childbirth.

Causes of transverse presentation of the fetus

Transverse fetal presentation is the wrong position of the fetus. This position of the fetus means that the closer to the exit of the uterus is the back of the fetus, and pelvic end and the head are located in the lateral parts of the uterus. It is the position of the fetus is absolutely not allow the child to be born.

Causes incorrect presentation of the fetus can be: narrow pelvis of the expectant mother, polyhydramnios or oligohydramnios, the presence of a tumor of the uterus, the placenta is too low or there are abnormalities in its development. Also significant factors affecting the position of the fetus may be too short umbilical cord, or entanglement of her neck, scars on the uterus after the operation, multiple pregnancy or degeneration of the myometrium.

Recommendations in case of incorrect fetal presentation

If the fetus in the womb adopts the wrong position, the woman recommended the implementation of special complex of exercises which helps to turn the baby. But to perform such gymnastics, there are the following contraindications: severe extragenital diseases, the presence of scars on the uterus from previous surgeries, preeclampsia in pregnancy, placenta previa and uterine tumors.

When not complicated by pathologies and the transverse position of the fetus, pregnancy often occurs without any features. In the case of complications during labor there is a possibility of rupture of the uterus, or even death, so in this situation the fetus, especially when combined with pathology, shown birth only by caesarean section.

If it is impossible to give birth the natural way, the woman should be a few weeks before the anticipated date of birth to enroll in a maternity hospital.

Advice 4: How to determine foetal hypoxia

Hypoxia of the fetus is insufficient flow to the fetus of oxygen, associated with diseases of the mother, disorders of uterine-placental or umbilical blood flow, diseases of the child. Diagnosis of hypoxia is based on the direct assessment of the fetus and analysis of the results of indirect methods.
How to determine foetal hypoxia
You will need
  • - monitoring perturbations of the fetus;
  • listen to heartbeats with a stethoscope;
  • - cardiotocography;
  • - doplerometriya;
  • - amnioscopy.
If you notice changes in motor activity of the fetus, it may be a sign of hypoxia. In the initial stage you can detect a troubled child's behavior, reflected in the frequency and strength of its perturbations. With the acute shortage of oxygen and buildup of hypoxia movements of the fetus begin to weaken.
Definitely watching you tell your doctor about changes of the perturbations. It with a stethoscope listens to the heartbeat of the fetus, assess heart rate, rhythm, presence of noise. However, this method can identify only gross changes, as often occurs in acute hypoxia. The doctor may suspect chronic hypoxia on circumstantial evidence, such as reducing the height of standing of bottom of uterus, associated with growth retardation of the fetusand oligohydramnios.
If you suspect hypoxia will be assigned a cardiotocography (CTG). This study successfully carried out in outpatient conditions. With elastic straps on a pregnant belly attached ultrasonic sensor, fixed in place listening to the heartbeat of the fetus. Diagnostic value has the frequency of acceleration and deceleration of heart rate. If increased heart rate is a response to the movement of the fetus or uterine contractions (at least 5 per 30 minutes), then we can talk about the prosperous condition of the fetus. To do this, in the framework of the CTG is non-stressful test, the essence of which consists in the appearance of ucashenie heartbeat in response to movement or contractions of the uterus. If the fetus does not give any reaction, this suggests hypoxia.
With the help of Doppler imaging is the study of blood flow in the vessels of the uterus, umbilical cord and fetus. If a disturbance in the circulation, it is possible to estimate the severity of hypoxia and to take measures for the further successful course of pregnancy. The first study is recommended at 16-20 weeks of pregnancy, since from this period of possible pathological disorders of the blood flow.
For diagnosis of hypoxia in a child are estimated amniotic fluid. About oxygen deficiency indicates the presence of amniotic fluid meconium - the feces of the fetus. Falling into the water due to the poor circulation in the intestine due to hypoxia. Relaxes the sphincter of the rectum of the fetus and the amniotic fluid meconium gets. With the help of amnioscopy are inspecting the optical device through the cervical canal and amniotic fluid. This method is often used prior to delivery.
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