During pregnancy, various physiological changes are observed, primarily related to of cardio-vascular system women. With the help of electrocardiography, some of them can be seen already in the first trimester. To understand whether the pregnancy is progressing normally or if there are abnormalities, ECG readings are deciphered.
Electrocardiography (cardiogram, ECG) is an additional research method that allows you to evaluate the functioning of the electrical conduction system of the heart. The study takes no more than 5-10 minutes and has a minimum number of contraindications.
To conduct an ECG, a special medical device is used, which, by placing sensors on the chest, arms and legs, records the electrical activity of the heart and displays the results on paper in graphical form or on a digital monitor.
During pregnancy, all women who register with the antenatal clinic are given an ECG twice. The first time is after the initial examination, which allows for a general assessment of the heart function of the pregnant woman. Second time - before registration maternity leave. If necessary, if there are symptoms of heart disease, an ECG can be prescribed at any time.
Video: Decoding the cardiogram: norm and pathology
Description of electrocardiography
The heart generates during contraction electrical impulses, which are detected using an electrocardiograph.
The first electrocardiogram was recorded by French physicist Gabriel Lippmann, who used a mercury electrometer. Later, the Dutch physiologist Willem Einthoven created a string galvanometer and was the first to determine the values of ECG waves.
When examining healthy hearts, the ECG has certain characteristics. If the ECG is abnormal, it may indicate a heart problem. Your doctor may recommend an ECG to help determine your risk of developing heart disease. This is especially true in cases where there is a hereditary predisposition to heart disease or another risk factor (smoking, excess weight, diabetes, high level cholesterol or high blood pressure).
ECG is a safe and non-invasive procedure without any significant risks and side effects for the health of the pregnant woman and child.
ECG procedure
There is no need to restrict yourself from eating or drinking before the test. It’s another matter when you are taking any medications and you should always let your doctor know about this. You also need to notify about the presence of any allergic reactions on adhesive tapes and substances that are often used to attach electrodes.
Before the test, you will need to remove your outer clothing so that the electrodes can be attached to your chest and limbs. (For women wearing a separate top with trousers or a skirt, easy access to the chest). In some cases, it is even recommended to remove your bra so that the doctor can properly apply the electrodes.
Suction cups or sticky gel are used to attach electrodes to the chest, arms and legs. Using installed sensors, electrical currents generated by the heart are detected - they are measured and recorded by an electrocardiograph.
Three main types of ECG:
- Standard ECG - indicators are taken in a calm state, when the woman lies on the couch and the doctor records an ECG for 1-2 minutes. During the procedure, movement is not allowed, since electrical impulses generated by other muscles can interfere with those created in the heart. This type of ECG usually takes 5 to 10 minutes.
- Ambulatory ECG - It is sometimes recommended to wear a portable recording device for at least 24 hours. This type of diagnosis is also called Holter monitoring. During the study, you can move freely and lead a normal lifestyle, while the connected monitor records the electrical activity of the heart. This type of ECG is suitable in cases where intermittent symptoms are detected that do not appear during a quiet ECG recording. Additionally, you need to record your symptoms in a diary and note when they occur, so that you can then compare them with an ECG
- Stress test (stress study) - this diagnostic method is used to record an ECG while riding an exercise bike or walking on a treadmill. This type of ECG takes 15 to 30 minutes to complete.
- ECG in the fetus (CTG, cardiotocography) - performed in the third trimester of pregnancy, most often at the stage of preparation for childbirth. Shows fetal activity and heart rate. If the study is done during childbirth, then the frequency of contractions.
When the procedure is completed, all electrodes are removed. An ECG is completely painless and non-invasive, since the skin is not injured in any way.
The doctor can interpret the ECG results based on the medical history, symptoms and clinical condition immediately after the examination, or the conclusion is sent to the pregnant woman a little later. As a rule, the conclusion indicates the heart rate (HR), the position of the electrical axis of the heart (right, left, normal), the correctness or deviations of the heart rhythm.
As an example, the following ECG conclusion (normal variant) can be given: Regular sinus rhythm, heart rate 85 beats/min, normal EOS.
Possible ECG complications
An ECG is a safe procedure with no known risks. The device does not transmit electrical current to the chest. Some people may have an allergy or sensitivity to the electrodes, which may result in redness of the skin, so any known reactions such as these should be reported to your physician prior to the procedure.
After the ECG there is no need to follow any regimens. The ECG is non-invasive and does not involve the use of medications (such as anesthetics), so there is no recovery time.
The ECG results allow the doctor to determine whether special treatment is needed or not.
Some of the different heart conditions that can be diagnosed using an ECG include:
- Cardiovascular heart defects associated with the conduction (electrical) system.
- Abnormal rhythm (arrhythmias) - fast, slow or irregular heartbeat.
- Damage to the heart, for example when one of the heart arteries is blocked (coronary occlusion), resulting in poor blood supply to the heart.
- Inflammation - pericarditis or myocarditis.
- Monitoring cardiac dysfunction due to improper chemical reactions(electrolyte imbalances) that control heart function.
- Previous heart attacks.
A woman with heart disease may have a normal ECG result if it does not cause problems with the heart's electrical activity. In such cases, other diagnostic methods may be recommended, especially if cardiac pathology is suspected.
Changes in the cardiovascular system during pregnancy
Profound changes begin to emerge already at early stages pregnancy, so that by eight weeks cardiac output has increased by 20%. Peripheral vasodilation occurs first. This is due to endothelial-dependent factors including nitric oxide synthesis, increased estradiol release, and possibly vasodilatory prostaglandins (PGI2).
Peripheral vasodilation results in a 25-30% drop in systemic vascular resistance, and to compensate for this, cardiac output increases by approximately 40%. Therefore, during pregnancy, tachycardia (rapid heartbeat) is often detected.
The work of the heart is mainly complicated by an increase in stroke volume, and to a lesser extent by an increase in heart rate. Maximum cardiac output is found at approximately 20-28 weeks of pregnancy.
An increase in stroke volume occurs against the background of an increase in muscle mass of the ventricular wall and end-diastolic volume (but not end-diastolic pressure). The heart physiologically expands and myocardial contractility increases. Although stroke volume decreases slightly at the end of pregnancy, the mother's heart rate remains the same, allowing her to maintain increased cardiac output.
Blood pressure decreases in the first and second trimesters, but increases to non-pregnancy levels in the third trimester.
There is a certain influence of a woman's body position on the hemodynamic profile of both mother and fetus.
- In the supine position, the uterus puts pressure on the inferior vena cava, which causes a decrease in venous return to the heart and a subsequent fall in stroke volume and cardiac output.
- Turning from a lateral to supine position can result in a 25% reduction in cardiac output. Therefore, if a woman is still breastfeeding during pregnancy, it is better to do this on the left or right side, if possible.
- If the woman is to lie on her back, the pelvis should be rotated so that the uterus descends away from the inferior vena cava and cardiac output and uteroplacental blood flow are normal.
Decreased cardiac output is associated with decreased uterine blood flow and therefore placental perfusion, which may cause adverse effects on the fetus.
Despite the increase in blood volume and stroke volume during pregnancy, pulmonary capillary pressure and central venous pressure do not increase significantly. However, pulmonary vascular resistance, like systemic vascular resistance, normal pregnancy is significantly reduced, so women in this position are more prone to pulmonary edema.
During labor, cardiac output increases even more (by 15% during the first stage of labor and by 50% during the second). Uterine contractions result in autotransfusion of 300-500 ml of blood back into the maternal circulation. The resulting sympathetic response to pain and anxiety further increases heart rate and blood pressure. Cardiac output increases between contractions and even more during contractions.
After birth, there is an immediate increase in cardiac output due to decreased pressure in the inferior vena cava and contraction of the uterus, which redirects blood into the systemic circulation. Cardiac output increases by 60-80% and then quickly decreases to the original level. Fluid entry from the extravascular space increases venous return volume and stroke volume.
Cardiac output almost returns to normal (pre-pregnancy values) two weeks after birth, although some pathological changes(eg hypertension during preeclampsia) may take much longer.
ECG indicators during pregnancy
The above physiological changes in the body of a pregnant woman lead to changes in the cardiovascular system, which may be misinterpreted as pathological. These may include a throbbing or collapsing pulse and a systolic murmur, present in more than 90% of pregnant women. The murmur may be loud and audible throughout the precordium, with the first heart sound being louder than the second heart sound. Additionally, ectopic strokes and peripheral edema may occur.
Normal ECG findings in pregnancy, which may in part relate to changes in cardiac position, include:
- Atrial and ventricular ectopic rhythms.
- Q-wave (small) and inverted T-wave in lead III.
- ST segment depression.
- Shorter than normal PR interval.
- T-wave inversion in the inferior and lateral directions.
- Left shift of the QRS.
- The electrical axis of the heart is deviated to the left.
- Heart rate is higher than normal.
Electrocardiography, like other diagnostic methods, has certain disadvantages:
- Not all heart diseases can be determined using an ECG, therefore, if there is suspicion and normal ECG results, cardiac ultrasound and other diagnostic methods are necessarily prescribed.
- A standard ECG is not able to “catch” signs of cardiac dysfunction if they were not present at the time of the study. This issue is partly addressed by daily ECG monitoring.
- ECG signs are often nonspecific, so it is often necessary to double-check the diagnosis with other research methods.
However, the absolute safety of ECG and the simplicity of the procedure make this type of diagnosis widely accessible, so it is used to study the condition of both seriously ill patients, children, and pregnant women.
Video: Cardiotocogram (CTG): what it is, how to interpret
The body of a pregnant woman experiences increased stress, and the cardiovascular system is no exception. From the moment of registration, a pregnant woman is regularly observed by specialists and undergoes necessary tests and undergoes examinations. This is necessary in order to monitor all changes in a woman’s body and monitor the progress of pregnancy. Electrocardiography is one of the instrumental research methods that is indicated for all pregnant women.
An ECG allows you to evaluate the work of the heart, heart rate, the condition of the heart muscle, the presence or absence of conduction and rhythm disorders. Sometimes pregnant women refuse to undergo examination, citing the lack of complaints or the fact that it could harm the unborn child. Expectant mothers need to know: ECG during pregnancy has no contraindications! An ECG during pregnancy is prescribed to all women upon registration. An ECG is a safe instrumental examination method for both the mother and the unborn baby at any time.
1 What does the doctor assess?
When deciphering the ECG, the specialist pays attention to the rhythmicity of the heart contraction, evaluates the source of the heart rhythm, calculates the frequency of heart contractions, correlates it with the conventional norm, the doctor also evaluates the position of the electrical axis of the heart, determines the time of contraction and relaxation of the atria and ventricles, studies the main teeth, intervals and ECG line segments.
Using the ECG film, the doctor can see disturbances in the rhythm and conduction of the heart, and the condition of the heart muscle as a whole. It is especially important to conduct an ECG in emergency situations, because a competent interpretation of the ECG in conjunction with the correct medical care can save the life of the expectant mother and baby.
2 Features of the ECG during pregnancy
Since the physiological indicators of a woman’s cardiovascular system change, it is quite obvious that when interpreting the ECG, a specialist will note some changes characteristic of pregnancy. Let's look at what changes on the ECG during pregnancy?
3 Heart rate
A pregnant woman is characterized by a tendency to have a rapid heartbeat of 80-90 beats per minute; a frequency of up to 100 beats per minute can be considered normal. On film, physiological tachycardia will manifest itself as shortening of the R-R intervals. The reason for the increased heart rate is that the volume of blood in a woman’s body increases, and the tone of blood vessels under the influence of an increased amount of hormones, on the contrary, decreases. Therefore, the heart needs to contract more often to cope with the increased load.
4 Changes in the electrical axis of the heart (EOS)
The electrical axis of the heart, especially on later pregnancy assumes a horizontal position. This is due to the fact that as the uterus enlarges, the dome of the diaphragm rises and the heart is located more horizontally, relative to its axis. After childbirth and contraction of the uterus, the EOS returns to its normal position.
5 Respiratory arrhythmia
On the ECG it is manifested by either shortening or lengthening of the R-R intervals during inspiration. Pregnant women, especially those with manifestations of vegetative-vascular insufficiency, may experience an increase in heart rate during inhalation and a decrease during exhalation, the so-called respiratory arrhythmia. This condition is associated with the predominant influence of the vagus nerve or nervi vagi and an imbalance of the autonomic nervous system. This is not a pathology, but a normal variant that often occurs during pregnancy.
6 Single ventricular or atrial extrasystoles
When interpreting the ECG, the doctor pays attention to the appearance of single complexes reflecting contraction of the atria or ventricles. If the patient does not complain and has no history of heart or vascular disease, then single extrasystoles are not a cause for concern.
Also, the features of the ECG of a pregnant woman include a slight decrease in the S-T segment, an increase in the height of the RI, SIII, QIII waves, a slight increase in the depth of the Q wave, flattening or biphasicity of the P wave in lead III, a biphasic T wave in lead III. These features must be taken into account by functional diagnosticians, therapists and gynecologists when interpreting the ECG of a healthy pregnant woman.
7 When should an unscheduled ECG be ordered?
A doctor observing a pregnant woman will definitely prescribe an ECG if she has the following complaints:
- pain in the heart, chest,
- heartbeat,
- feeling of “freezing” of the heart,
- shortness of breath, lack of air,
- severe weakness, dizziness,
- fainting states.
Of course, many of these complaints may simply indicate a woman’s “interesting” position and indicate a restructuring of the body during pregnancy, but it is better to be safe to some extent and have an extra cardiogram done than to miss the onset of cardiovascular pathology.
An ECG is required if a pregnant woman’s blood pressure “jumps” from low to high numbers, as well as if complications of pregnancy have developed: toxicosis, gestosis, oligohydramnios or polyhydramnios.
8 How is the research conducted?
Carrying out an ECG in women during pregnancy is no different from doing it in other patients. The examination is carried out in the supine position, the procedure is absolutely painless. The woman should not exercise before the procedure physical exercise, 1-2 hours before, it is recommended to avoid eating, smoking, and drinks containing caffeine. General fatigue, a full stomach, and harmful addictions can distort the results of the examination.
A pregnant woman's clothing should be loose so that she can easily expose her chest, hands and ankles - the places where the electrodes are attached. During the ECG, the woman must be absolutely calm, breathe freely and evenly. If a health worker notices a pregnant woman’s anxiety before the procedure, he is obliged to calm her down, explain that the manipulation is completely safe, it can be performed repeatedly at any stage of pregnancy without any negative consequences for the fruit.
After an ECG, a woman should avoid sudden rises from the couch, since in late pregnancy, too rapid a transition from a horizontal to a vertical position can cause orthostatic hypotension and even fainting.
Despite the fact that ECG has been used for more than 100 years and every person has undergone such an examination at least once in his life, many patients still have mistrust in this method. This is especially true for pregnant women, as they are suspicious of any research due to concerns about their unborn child. Let's dispel the myths and find out at what time and why an ECG is performed during pregnancy, whether it is harmful to the mother and fetus, and how such a study is carried out.
Electrocardiograph
Why is electrocardiography necessary for women expecting a child?
Many women are rightly indignant: why do they need such a routine examination as an ECG during pregnancy, when they already need to go through a bunch of other offices. And in vain! An ECG is a unique method that allows you to examine a huge number of people (that is, it is a screening method) and identify initial disturbances in the functioning of the heart. It is cheap and accessible, available in all medical centers, no matter what remote locality you live in, and its main quality is safety. This is one of the few methods that are harmless to both mother and fetus.
The reason why you need to go for an electrocardiogram during pregnancy is very simple: the heart of such a woman is subject to increased stress and disorders that were compensated in the past can now develop into full-fledged cardiovascular diseases. The load on the heart of a pregnant woman is caused by an increase in the volume of circulating blood, as well as changes in the concentration and composition of hormones.
Interesting fact: the longer the pregnancy, the more the heart turns counterclockwise. The growing uterus raises the diaphragm, the apex of the heart deviates more and more to the left and gradually it takes a horizontal position.
When is electrocardiography performed?
When registering, a pregnant woman is sent for an ECG
An ECG during pregnancy is performed at least twice: when a woman is registered and in the later stages, when doctors are planning labor management tactics. If the first cardiogram caused concern among doctors, then the pregnant woman is referred to a cardiologist, who will further examine her and confirm or refute the alleged diagnosis.
It should be noted that hormonal changes and changes in hemodynamics often confuse the doctor, thus causing false-positive diagnoses. During pregnancy, it is quite difficult to judge whether the disease is genuine or simply caused by the physiology of pregnancy, so there is no need to panic in advance. In general, electrocardiography can be done an unlimited number of times throughout pregnancy, and we will look at why below.
Is electrocardiological testing really that safe?
ECG is a method of “non-intervention” in the body. It is non-invasive and simply records the electrical potentials that occur when the heart beats. The ECG device does not emit ionizing radiation and does not generate a magnetic field. Interestingly, the first electrocardiogram performed during pregnancy dates back to 1913. For more than a century of use of the method, there have been no recorded cases negative influence electrocardiography per person.
What pregnancy-related disorders can electrocardiography detect?
The ECG conclusion usually includes indications of the rhythm frequency (normally 80–90 beats per minute), the type of rhythm (normally sinus), the electrical axis of the heart is located within 30–70 degrees (during pregnancy, 70–90 is not a pathology). Minor changes in heart function after the birth of a child return to normal.
Deviations that are considered normal during pregnancy, but require additional examination and supportive therapy for the heart muscle:
- Various functional noises.
- Isolated cases of atrial or ventricular extrasystole.
- Constant ventricular or atrial rhythm.
- Atrial tachycardia.
- Incomplete atrioventricular block.
The main task of the doctor in this case is to determine by prescribing an ECG when the values are within the normal range and when they indicate an unfavorable state of the cardiovascular system. And the patient needs to inform the specialist about shortness of breath, fainting, palpitations and other symptoms that were absent before pregnancy. What seems like a normal pregnancy condition to you may actually be the first sign of heart disease.
Pregnant woman at an appointment with a cardiologist
Although pregnancy is a physiological condition and not a disease, it places significant stress on a woman's body. And in the case of electrocardiography, it is better to do it regularly than not to do it at all. The test does not require any preparation, is painless and does not take much time during pregnancy, but the results obtained during its course can prevent the development of heart disease and even save lives.
The study of cardiac activity using an ECG is a mandatory type of diagnosis during pregnancy. A woman is sent for cardiography when she first visits a doctor to assess the functioning of the heart and the risk of its overload while carrying a child. This is due to the fact that even a normal pregnancy creates an increased load on the myocardium and blood vessels. An ECG is routinely prescribed upon registration and before birth..
The reason for an extraordinary examination may be:
- pain in the heart area;
- shortness of breath, swelling, enlarged liver;
- feeling of interruptions in rhythm;
- changes in blood pressure;
- severe toxicosis;
- previous infection;
- excess body weight.
Regular ECG monitoring indicated in the presence of any heart disease, kidney pathology, endocrine system, lungs. A cardiogram is important when prescribing medications to a pregnant woman for the treatment of hypertension, arrhythmia, and heart failure.
If abnormalities are suspected, the cardiologist may prescribe an additional study - Holter monitoring. Stress tests and functional tests during pregnancy have limited use.
Cardiotocography– a combined method of examining mother and fetus. The procedure is prescribed at least 2 times during the third trimester. The first time you can perform a fetal ECG is at 14 weeks intrauterine development . Unscheduled diagnostic sessions are recommended when identifying:
- late first pregnancy;
- spontaneous abortions in the past, abortions, threatened miscarriage;
- endocrine diseases;
- late toxicosis;
- for chronic pathologies;
- signs of developmental abnormalities;
- post-term pregnancy;
- oligohydramnios.
Cardiotocography can also be performed during childbirth. if there is a threat to the child’s cardiac activity.
The procedure is considered completely safe and can be performed repeatedly according to indications.. If long-term monitoring of heart function is necessary, an ECG is performed continuously for several days. No disturbances in the condition of the mother and fetus were recorded.
ECG does not require special preparation, it can be carried out on an emergency basis . Important condition– maintaining emotional and physical rest for at least 20 minutes before diagnosis. On the day of the study, you cannot have tonic drinks, and at least one hour must pass after eating. During an ECG, you should not move; if you are cold to the point of shivering, inform the staff.
U healthy woman there is a sinus rhythm with a frequency of 60 to 90 beats per minute, and the eclectic axis occupies an angle of 30 to 90 degrees. In the fetus detect a basal contraction rate of 110 - 160 beats per minute. This indicator is calculated as an average over 10 minutes or more. If serious abnormalities are detected, a caesarean section is indicated.
Permissible deviations that do not require therapeutic measures:
The fetus may have tachycardia (more than 200 beats), if it is combined with arrhythmia, then this is a sign of conduction disorders of the heart muscle, and with 230 or more - inaccessibility of blood circulation. A slow rhythm occurs during oxygen deprivation, but also occurs during elevated temperature, disruption of labor.
A single study does not always reflect the real clinical picture . In doubtful cases, additional diagnostics are indicated, including daily monitoring.
For an accurate diagnosis, additionally prescribed blood tests, blood pressure measurements, ultrasound of the heart with Doppler sonography. Complaints and the history of their occurrence, as well as medical examination data, are taken into account.
Before determining the cause of violations, it is necessary follow recommendations for the duration of night sleep, daytime rest, and a diet limiting animal fat, sugar and flour products, the diet should include juices, vegetables, nuts, low-fat dairy products, meat and fish.
Read more in our article about performing an ECG during pregnancy.
Read in this article
Is it possible to do an ECG during pregnancy?
The study of cardiac activity using an ECG is a mandatory type of diagnosis during pregnancy. A woman is referred for cardiography at her first visit to a doctor to assess her heart function. and the risk of overloading it during pregnancy. This is due to the fact that even a normal pregnancy creates an increased load on the myocardium and vascular bed. The main changes include:
- increased rhythm of contractions;
- increased blood volume in the vessels;
- an increase in blood ejection from the ventricles by almost half;
- overload of the left side of the heart.
Routinely, an ECG is prescribed upon registration and before birth. The reasons for an extraordinary examination may be:
- , enlarged liver;
- frequent and strong heartbeat;
- feeling of interruptions in rhythm;
- fainting, frequent dizziness;
- listening to pathological noises or disturbances in the rhythm of beats during examination;
- severe toxicosis;
- previous infection;
- excess body weight.
Regular ECG monitoring is indicated in the presence of any heart disease, pathology of the kidneys, endocrine system, or lungs. A cardiogram is important when prescribing drugs for the treatment of heart failure to a pregnant woman.
What does a cardiogram show?
By recording cardiac impulses you can detect:
- Do myocardial contractions occur regularly, is there an arrhythmia;
- the presence of extraordinary or ectopic (from an abnormal location) complexes ();
- acute or chronic deficiency of coronary blood flow (ischemia, angina, heart attack);
- violation of the conduction of electrical impulses ();
- signs of blockage of the pulmonary arteries (thromboembolism);
- lack of potassium;
- hypertrophy or dystrophy (increase in the volume of muscle fibers or depletion) of the myocardium.
It is not always possible to detect such violations in the usual way. Therefore, in addition to the standard ECG, the cardiologist may prescribe an additional study - Holter monitoring. Stress tests and functional tests during pregnancy have limited use.
Holter monitoring What is the optimal time for the fetus?
An ECG is necessary not only for the mother, but it is also recommended for assessing the condition of the fetus. Typically, a combined method of recording uterine contractions and studying fetal cardiac activity - cardiotocography - is used.
- late first pregnancy;
- The procedure is prescribed at least 2 times during the third trimester. The first time you can perform an ECG of the fetus is at 14 weeks of intrauterine development. Unscheduled diagnostic sessions are recommended when identifying:
- spontaneous abortions in the past or surgical termination of pregnancy, threat of miscarriage;
- endocrine diseases;
- late toxicosis;
- previous inflammations, tumors;
- hypertension, symptomatic hypertension;
- Rh-conflict pregnancy;
- autoimmune or any other chronic pathologies;
- signs of developmental abnormalities;
- post-term pregnancy;
- oligohydramnios.
hereditary predisposition to heart disease;
Cardiotocography can also be performed during childbirth directly from the presenting part of the fetus if there is a threat to the child’s cardiac activity. Cardiotocography
Is ECG harmful for mother and baby? An ECG examines the bioelectric impulses that cause heart contractions. They are recorded using special sensors that perceive the signal and a device that converts it into a graphic image.
At the same time, the body is not adversely affected by physical factors.
In a conventional ECG, the electrodes are placed on the chest and limbs, and in cardiotocography, on the abdomen.
The procedure is considered completely safe and can be performed repeatedly according to indications.
If long-term monitoring of heart function is necessary, an ECG is performed continuously for several days. No disturbances in the condition of the mother and fetus were recorded.
An ECG does not require special preparation and can be performed on an emergency basis. An important condition is to maintain emotional and physical rest for at least 20 minutes before diagnosis. If the procedure is planned, then on the day of the examination you should not drink tonic drinks, and at least one hour should pass after eating.
During the recording of the cardiogram, it is necessary to exclude movements; if the room feels cool, then you should inform the medical personnel about this, since muscle tremors can significantly distort the resulting recording.
Watch the video about performing an ECG:
Decoding indicators
After recording the necessary ECG leads or cardiotocography, the resulting curve must be deciphered and described by a cardiologist or functional diagnostics physician.
Normal for mother and fetus
Normal heart activity is shown as typical waves and intervals. First, a dome-shaped atrial P wave appears, and then the impulse travels along the conduction pathways to the ventricles, which is reflected by the ventricular QRS complex. The T wave characterizes the wave of repolarization, that is, the restoration of the electrical charge to its original values.
A healthy woman has sinus rhythm, with a frequency of 60 to 90 beats per minute, and the eclectic axis occupies an angle of 30 to 90 degrees. There should be no rhythm or conduction disturbances, myocardial hypertrophy, dystrophic changes or ischemia.
The fetus has a basal contraction rate of 110–160 beats per minute. This indicator is calculated as an average over 10 minutes or more. If deviations from this norm are detected, the doctor can use stress tests to determine the fetus’s ability to endure independent labor.
Physical activity, administration of medications, a test with rapid breathing or holding it, and reflex tests are used. If serious abnormalities are detected, a caesarean section is indicated.
Changes
During pregnancy, under the influence of hormones and the appearance of a growing fetus, some performance indicators internal organs are changing. These changes also affect the heart. Therefore, there are acceptable deviations that do not require therapeutic measures:
- tachycardia within 95-100 beats per minute;
- the electrical axis shifts to the left;
- the interval from the atrial to the ventricular complex lengthens;
- in the third and fifth leads T is flat or negative.
Tachycardia (more than 200 beats) may be detected in the fetus; if it is combined with arrhythmia, then this is a sign of conduction disorders of the heart muscle, and if 230 or more - inaccessibility of blood circulation.
A slow rhythm occurs with oxygen starvation, but it also happens with elevated temperature and disruption of labor.
It should be borne in mind that the heart rate is not constant, so a single study does not always reflect the real clinical picture. In doubtful cases, additional diagnostics are indicated, including daily monitoring.
What to do if there is a bad ECG
The diagnosis is not made on the basis of newly detected ECG changes. Usually, more in-depth diagnostics are required - blood tests, blood pressure measurements, ultrasound of the heart with Doppler sonography.
Complaints and the history of their occurrence, as well as medical examination data are taken into account.
Until the cause of the violations is determined, it is necessary to follow recommendations on the duration of night sleep, daytime rest, diet with a limit of animal fat, sugar and flour products, the diet should include juices, vegetables, nuts, low-fat dairy products, meat and fish.
It is strictly forbidden to independently carry out treatment not only with medications, but also with herbs and dietary supplements. Complex therapy should be prescribed only by a cardiologist; he monitors the pregnant woman before and after the birth of the child.
An ECG during pregnancy is prescribed routinely and if there is a suspicion of cardiac dysfunction. In the third trimester, cardiotocography is performed twice to study the fetal cardiac activity. Both of these procedures are completely safe and can be repeated several times if necessary. The interpretation of the results is carried out taking into account
physiological changes
in the cardiovascular system of a pregnant woman. Detected deviations from the norm require additional examination to make a diagnosis.
One of mandatory diagnostics The test you need to undergo during pregnancy is an ECG. Reason for examination – hormonal disbalance, which can negatively affect the heart health of the expectant mother. Is it possible during pregnancy and is it harmful? First things first.
ECG, or electrocardiography, is one of the oldest methods for testing the functionality of the cardiovascular system, which makes it possible to detect serious diseases and pathologies in the early stages of development. Determines heart activity and records data on graph paper.
ECG during pregnancyWhy is an ECG performed during pregnancy?
During pregnancy, this is the only method by which to actually diagnose the functionality of the heart muscle in expectant mothers, since they complain of:
- Shortness of breath.
- Cardiopalmus.
- Fatigue quickly.
- Painful sensations in the chest.
Shortness of breath during pregnancy Already during the first months of pregnancy in women, cardiac output increases, peripheral edema appears and the jugular vein pulsates strongly. Only an ECG during pregnancy will help you understand the real reason pain in the heart area and distinguish them from such ailments:
- Muscle spasm.
- Gastroesophageal reflux.
- Pneumonia.
- Compression of the esophagus.
- Gastritis.
- Panic attack, etc.
How to prepare for the procedure
- Do not eat 2.5 hours before the diagnosis.
- Do not be nervous.
- Sit quietly before the procedure for 10-15 minutes.
How to do an ECG for pregnant women
The research consists of several stages:
- The woman exposes her lower leg, forearms and chest, lies down on the couch.
- The specialist applies a gel to these areas that improves the passage of current and attaches the electrodes.
- The cardiograph is started, after which the work of the organ is recorded.
Is it possible for pregnant women to have an ECG often?
According to the standard, the study is done only once when the patient is registered with antenatal clinic. But if complaints appear, or the doctor suspects the presence of cardiac pathologies, the pregnant woman is urgently sent for an ECG.
Reasons why you need to do a repeat heart examination:
- Sudden changes in blood pressure.
- Fainting and dizziness.
- Dull pain in left chest.
- Increased heart rate.
- Problem breathing.
- Prolonged toxicosis.
Dizziness during pregnancy You can do a cardiogram at any period of pregnancy and not worry that it is dangerous for mother and child.
Features of ECG of pregnant women
When analyzing diagnostic data, experts take into account physiological characteristics patients. For example: carrying a child provokes an increase in heart rate. This is explained by the fact that the pressure on the heart gradually increases, and it needs to process a lot of blood. In parallel with this, the heart rate should not be more than 80 r./min.
During pregnancy, extrasystole may appear - additional heart contractions. This is due to the fact that during pregnancy, excitation manifests itself not only in the sinus angle, but throughout the heart. If expectant mother atrial or ventricular contraction is systematically recorded, she will be prescribed additional examination.
In case of a poor ECG during pregnancy, the patient requires re-diagnosis. If the results are repeated, the woman is prescribed ultrasound diagnostics heart, which can identify the cause of failures and select optimal therapy.
Why do heart problems occur in pregnant women?
Illnesses can be caused by:
- Mental disorders.
- Hormonal imbalances.
- Diseases of the central nervous system.
- Hereditary heart diseases.
- Exacerbation of existing cardiac ischemia, myocarditis.
- Congenital defects.
- Neoplasms in the heart.
Decoding the results
The decryption of the received data should be carried out by a qualified specialist. The only thing a woman can see for herself is her heart rate readings. Normally, this figure varies between 60-80 rubles/min.
Important! Pregnant women are characterized by tachycardia and bradycardia, therefore, if the pulse is 100 beats per minute with normal blood pressure, the woman does not need to worry.
For some women normal indicator The pulse rate is 110-130 r./min, so if you do not know your body well, there is no need to draw hasty conclusions from the cardiogram. In any case, if the ECG norm is violated, the pregnant woman is sent to a cardiologist, who will select her treatment taking into account individual characteristics and the nature of the illness.
ECG of the unborn child
An ECG of the fetus during pregnancy is called cardiotocography. This diagnostic shows the following data:
- Baby's heart rate.
- Movement of the fetus in the womb.
- Regularity of uterine contractions (if an ECG for pregnant women is performed shortly before birth).
The procedure is completely safe and does not cause discomfort to mother and child. To carry it out, sensors are placed on the woman’s stomach, which record the required information for forty minutes. Decryption is carried out by a specialist immediately.
Indicators that cardiotocography measures:
- Pulse. Normally - within 110-170 beats/min. If minor deviations up or down are recorded, this indicates minor violations. Indicators below 100 or more than 180 are considered dangerous symptom.
- or heart rate indicators in a calm and active state of the baby. The difference between these figures is within 10-25 rubles/min. Violations of 5 strokes in both directions are not considered a dangerous symptom. But if a baby’s heart rate in a calm and active state differs by only 5 beats, this indicates serious problems.
- The child's reaction to external movements, music or stimulation. If your baby's heart rate increases, then everything is fine.
The above criteria give doctors the opportunity to understand the child’s condition and the correctness of his development. Cardiotocography, together with other diagnostics, helps to identify fetal hypoxia, and in the worst case, influences the decision on artificial birth or caesarean section.
The study is prescribed only after the 32nd week of pregnancy. Previously, it is not carried out, since the fetus has not yet fully formed reactions to external stimuli.
Fetal ECG Finally
Electrocardiography during pregnancy and fetal cardiotocography are universal methods for checking health. Due to their harmlessness, effectiveness and lack of inconvenience during their implementation, they help to timely detect and eliminate ailments that interfere with the comfortable bearing of a child.
More and more specialists are seeking to introduce CTG during childbirth, especially in those where some complications are possible.
More:
How to decipher an ECG analysis, norms and deviations, pathologies and diagnostic principles
