- topicPregnancytagged by System, 3/3/12
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Fetal cardiac arrhythmia, svt, tachycardia, fast heart ratepost #1 of 83/3/12 at 9:49pmThread StarterI am pregnant w/ my 4th, my last two births were at home, no complications. First birth, I was put on a clock and pressured to have a c-sect after 20 hours of back labor w/o any drugs due to my water leaking and being in labor so long. I later found out I could have refused. None- the-less, this pregnancy has been pretty good except my first u/s indicated placenta previa - not unusual. After consulting with my midwife, I opted for the more advanced stage 2 u/s to rule out previa. It was resolved completely, however, the baby's HR was over 240 during the u/s which is truly unusual. It has not been higher than 150's in the three times it was checked. I am currently 27 weeks. Unfortunately the doctor I saw after 2.5 hours of monitoring was extremely out- of-line insisting I be admitted immediately and take some drugs. I can't help but to believe it has something to do with my own health. I was struck by an intense virus over 3 weeks ago meanwhile my husband and all the children were also affected. I spent 3 days in bed with chills, body aches, extreme exhaustion with difficulty breathing. In fact, getting out of bed just to go to the bathroom would wind me and wipe me out. Breathing seemed to be a chore which only went away completely today. I finally feel like I am getting back to normal. I lost all the weight I gained since getting pregnant and I wasn't able to eat a whole lot due to the constant nausea we all experienced. It was by far the worst virus I have ever had. I did have a fever, but it only 101 on one occasion, otherwise when I had a fever it was below 101. The rest of the family had a fever in the 102 range. I know I most likely have a magnesium deficiency due to the illness, so have been taking supplements, using magnesium oil, and taking other enzymes known to help with heart disease. I also began the liquid oxygen in last few days and it has seemed to work wonders with my breathing issue (getting winded when I read books to the kids & climb stairs). It was not as if I could not breath, but that it was such a chore to do any physical activity that required any form of exertion. I visited my midwife on the Air Force base this past Wednesday and the heart rate was more consistent (not erratic and not as much kicking/moving by the baby during the Doppler check). When the heart rate was in and above 240 it would drop to a normal rate after the baby kicked. This time it just stayed at 220 consistently. I've noticed the baby's movement has seemed to chill since the u/s and doesn't seem to be so intense. I am hoping and praying that the issue will be to resolved by the time I go for a ECG at the children's hospital next Thursday. I've done a lot of research on the matter and have read that the baby has a 1-2% of having SVT which can lead to a heart attack in the womb. Other reading had stated that this usually resolves at birth. There are also different forms/causes of SVT and fetal tachycardia and they should be careful to diagnose it properly. I am hoping and praying for a miracle! Would love to hear what you have to say or what you may know about this particular condition. On the u/s the heart was normal just a really high heart rate, so I am hopeful that it may be caused more by maternal stress and health.post #2 of 83/4/12 at 2:29am
I am not a midwife or ob/gyn nurse, but I am a baby and kid nurse with some ICU training. I also cannot comment on your specific case or diagnose anything (have to put in a disclaimer).
When a person has a severe illness and fever their blood circulation will shift from what it considers non-essential organs to more essential organs. The body's metabolism also rises quite a bit. My guess is that the baby's metabolism will also rise quite a bit, and the blood flow to the placenta may be temporarily altered from the norm.
I see infants on our unit with heart monitors on who have pertussis or RSV, and their heart rates are of course higher because of fever. When they have a coughing fit or cry, the monitors go crazy and show tachycardia past the normal parameters, and often show SVT or PVC or even asystole (stopped heart). A lot of this is just the movement of their bodies during the coughing/crying, and it looks a lot worse on the monitor than it does in real life by looking at the actual patient. I am wondering if you had a similar thing going on with your monitors not being quite accurate since the baby was kicking and active.
Also, what we look at with our babies, is not that they do get tachycardic sometimes, is do they stay that way or go back to normal when the couging stops- and do they recover quickly afterwards. If they do that's a good sign.post #3 of 83/4/12 at 8:05am
HUGS! I am sorry that you are going through this. I know from personal experience how incredibly stressful it can be worrying about your unborn baby (my son had some issues on u/s too). I hope that your recovery from your illness is going well. I don't really have a lot of information that I can offer. Like the previous poster, I am not a midwife/ob so I can't give a lot of insight into what caused this change all of a sudden, but I am a NICU nurse, and I do see some kiddos that have had problems with cardiac arrhythmia's in utero. Generally, depending on what caused the arrhythmia's and what type it is, there is a lot that a cardiology team and NICU can do (if necessary) to solve it and the kids seem to do OK after they have been born. A resting heart rate of 220-240 is definitely out of the range of normal, although it doesn't necessarily mean that the baby is in SVT. When I do see babies in SVT, their heart rates tend to be more in the 260-270 range, and then they can really get into trouble. But, I have never run across a case of SVT that we couldn't fix, either. Of course, this is after the baby is born, I have no idea what they can do before the baby is born - sorry! It may be the case the this illness that you had did stress your baby, and stressed babies have high heart rates. It may also be a totally unrelated thing that just happened at the same time. One thing that we see with some regularity with babies with high heart rates/ intermittent SVT are Mom's that have thyroid issues. Have you ever been diagnosed with hyper/hypothyroidism? It might be worth having your midwife check your levels. Just a thought.
On another note, if it were me, I wouldn't attempt a homebirth with this baby. I switched from planning a birth center birth (possible homebirth - I was still considering it) to a hospital birth just in case. Birth is a very physiologically stressful time for babies that require a lot of changes in the heart to switch from fetal circulation to adult circulation. Ducts in the heart need to close, the blood can no longer be shunted from the lungs, and the pulmonary arteries have to be nice and dilated for the transition from life in womb to outside of womb to be successful. Given the fact that there is some question about cardiac arrhythmia's, it is possible (not likely, but more likely than in the general population) there might be an underlying cardiac defect that won't be fully appreciated until the baby is born. Does your midwife deliver at a university hospital? Outcomes for babies with possible problems tend to be much better there than at small hospitals with a lower level NICU (although the rate of OB intervention in birth is atrocious!) Just a thought. At any rate, I hope your baby has a nice, healthy heart rate at your next check, and this is all is just pronounced "one of those things we will never know what caused it, but we don't care because it is better". It is a decent possiblity. If your baby does need some help, I guess what I am trying to say is that it will still likely work out well. I am truly hoping for the best for you. Keep us posted! Good luck!post #4 of 83/10/12 at 5:30am
i am an l&d nurse, who has recently had 3 different patients with fetus' in SVT. i work in a very high risk ob setting, but also a very naturally inclined baby friendly hospital, where my last 4 patients labored and birthed with out epidurals. so don't get me wrong. i'm as crunchy as a medically minded person can be. i used to be even more crunchy, but i've learned better.
At my hospital, the women who were pregnant with babies in SVT were admitted to the ICU and given drugs to cardiovert the baby's heart back into a normal rhythm, a fetus will not last in SVT forever. a baby can be in SVT anywhere above 200, but i've also seen fever induced tachycardia to 200, above 200 is more from that.
2 of the babies cardioverted back to normal rhythms with digoxin and were delivered, and will have SVT intermittently probably always, and have to carry around emergency medications, or take daily meds.
the 3rd baby we were not able to cardiovert out of the arrhythmia through the mom, and that baby was delivered because it was developing hydrops and needed a pace maker.
i wouldn't mess around with a diagnosis of a serious arhythmia. seriously. if you want a living healthy baby its no joke.
at such a high heart rate, the babys heart is not perfusing it's little body well. the heart is in a flutter, and they can develop hydrops, and or die in uteru.
SVT in a fetus is not a joke. its more manageable baby out than in. because they can treat the baby directly as opposed to giving the mother digoxin for cardioversion
you having been very sick and having a fever- could have caused something to go wrong with fetal development, i would continue to get this checked out.
i wish you the best of luck, and please if your health care provider suggests you go get treated. please go get treated. this is not something to be messing around on the internet message boards with
i wish you the best of luck, and i hope your little one cardioverts himself back to a nice normal 120-160.
update us!post #5 of 83/18/12 at 5:58pmThread StarterPraise God! The baby has been normal for over a week now. I bought a Doppler and have checked it almost every morning and night. While it is resting it has been in the 120s and the highest I've detected while active has been in the 150s. My midwife also checked it and it was 140-170 during the mid afternoon while awake and active. I had a second ECG and it was normal before and after the ECG. Now that I am not struggling to breathe myself I am happy to see the baby is normal. Also, there is nothing mechanically wrong with the heart, nor has any extra fluid formed around the heart due to the high heart rate. I appreciate each of you replying. Even the doctor was comfortable with me not taking any drugs as long as we monitored the heart rate over the next four weeks. She was pretty confident that the illness and stress I had really affected the baby's health and that the only thing going on is possibly with the electrical system of the heart which is still developing and can cause an elevated heart rate until the extra connecters go away. But it not something they can see, they only know it on theory with how the heart operates.post #6 of 84/24/12 at 1:30pmQuote:
Thank goodness everything turned out well for you. We had a similar issue in that we were going to have a home birth, but then when my wife went into labor, the baby's heart rate shot up to 240 and we ended up having to transfer to a hospital. Baby was born with no problems though, as the heart rate fell after the water broke. Full story is:
Baby is 14 months old now, no health problems at all aside from the normal baby teething pain.post #7 of 84/24/12 at 1:33pmpost #8 of 84/30/12 at 10:57amThread Starter
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