Low Fetal Heartrate During Pregnancy

Low fetal heart rate is not always a problem and may be considered normal for a short period.

However, when it happens for a prolonged period, it may indicate other more significant issues that your doctor should recognize.

That’s why in this post we discuss the dangers of a low fetal heart rate during pregnancy, labor, and delivery.

Let’s begin.

What Is a Low Fetal Heartrate?

Medical professionals expect a fetal heart rate to be faster than that of a healthy adult.

The medical professionals at Johns Hopkins state the expected fetal heart rate for a fetus is between 110 and 160 beats per minute (bpm), with an expected deviation of 5-25 bpm.

It can be normal for these rates to change as the baby moves or conditions in the uterus change.

A prolonged change or drop in heart rate, however, should be considered a red flag to investigate further because it may indicate more concerning situations.

Sinus Bradycardia

Sinus bradycardia is identified in patients who show a low heart rate but lack other concerning symptoms.

Sinus bradycardia patients typically show normal function of the heart’s electrical system, but the heart rate stays below 110 bpm.

Problems with electrical functioning are commonly referred to as heart block and may be caused by a few problematic mechanisms.

Atrioventricular Block

The atrioventricular block is considered a first-degree block and occurs when electrical signals between the heart’s upper and lower chambers are prolonged.

This causes a slower electrical pulse, triggering the heart to pump. The reduction in electrical pulses causes a reduced heart rate.

Partial Heart Block

A partial heart block, also known as a second-degree block, occurs when the impulse does not reach the heart’s ventricles immediately after entering the chamber.

This can cause a slower heart rate or skipped heartbeats.

Sometimes, a partial block may develop into a complete heart block. Partial blocks do not generally require intervention but may if the heart rate cannot sustain the body.

Complete Heart Block

A complete heart block occurs when impulses cannot connect the upper and lower ventricles.

A complete heart block is also known as a third-degree block and is only survivable with medical intervention.

Causes of Fetal Bradycardia

There are many reasons your child may experience fetal bradycardia, and the reasons pose varying levels of concern.

Generally speaking, bradycardia caused by heart blocks suggests more congenital problems related to the fetus’ physiology and complications surrounding the electrical impulses.

However, sinus bradycardia may have more external or environmental factors that cause this kind of fetal distress.

Maternal Influence

Conditions inside the mother’s body or uterus that may cause a low fetal heart rate include conditions like hypotension or hypothyroidism.

Additionally, an emergency for the mother, such as a placental abruption, can cause fetal bradycardia.

Sometimes, the mother’s position can affect heart rate or put more strain on the baby’s system and contractions during labor.

It is not uncommon to see brief decelerations in the baby’s heart rate while the birthing parent is contracting, though this is not generally referred to as bradycardia since it is short-lived.

Medications may also affect the baby’s heart rate.

Physical Stress

Some situations that may cause significant physical stress to the fetus include the situations mentioned above, as well as umbilical cord compression.

An umbilical prolapse occurs when the umbilical cord falls through the cervix during labor, putting prolonged pressure on this organ and decreasing blood flow to the fetus.

Problems like cord compression are not typically diagnosed during pregnancy because movement is so frequent that it is rarely a lasting problem.

However, it can become dangerous during labor if it is prolonged.

When the amniotic sac ruptures and the cervix dilates enough to allow the cord through, this is considered a prolapse and often considered emergent.

A situation like this may cause the fetal heart rate to drop below 60 bpm during labor. This is not considered a preventable situation, and fetal survival is dependent on your medical team quickly identifying the problem and intervening.

Treating Low Fetal Heart Rate

The treatment for a low fetal heart rate begins with fetal monitoring, as explained in the Johns Hopkins citation above.

This monitoring can help your provider determine if the problem is ongoing or a result of positioning or other temporary factors.

At Lopez, McHugh LLP., we are aware that these conditions may be difficult to predict. However, we are determined to hold providers accountable if they fail to take the appropriate steps to monitor any possible concerns.

If imaging and other testing determine that the fetus has a second or third-degree heart block, the treatment is often surgery.

Surgical intervention includes implanting a pacemaker after birth to stimulate an appropriate heart rate. In an infant, the pacemaker is placed under the skin with the leads placed on the surface of the heart.

Treatment for low heart rates associated with pregnancy or labor complications is most often delivery.

In cases like Intrauterine Growth Restriction (IUGR), a physician may choose to monitor the fetus, checking for a sustained low heart rate, among other things. If they determine significant problems, they may advise an induction of labor.

For families in the Philadephia area, this may mean delivery in a specialized unit like the Garbose Family Special Delivery Unit, where providers are especially focused on fetal heart-related complications.

In instances of cord prolapse or other prolonged compression during labor or delivery, the treatment is often an emergency cesarean.

Long Term Consequences

When a low fetal heart rate is associated with symptoms like hypoxia, as seen with cord compression, or other problems where the baby is not receiving oxygenated blood, there may be significant long-term consequences.

These may affect the child and, in some cases, the birthing parent.

The parent may be affected if physicians fail to identify fetal distress and other indicators that may suggest concerns with the birthing parent, such as placental abruption, which could be fatal to both parent and baby.

Other concerns that may cause fetal bradycardia include hypotension or adverse responses to medication.

Anoxic Brain Injury

The long-term consequences of prolonged low heart rate during labor or delivery can include brain damage due to anoxic brain injury.

When the heart is not beating quickly or efficiently enough to circulate oxygenated blood, this can cause tissue death in the brain. Similarly, if the blood supply is cut off by cord compression or other means, the heart rate may lower.

When this is not caught in time, the lasting effects can include:

• Developmental delays
• Cognitive deficiencies
• Cerebral Palsy
• Weak muscle tone
• Seizures

Call a Philadelphia Birth Injury Lawyer Today

If your child demonstrated a sustained low fetal heart rate during pregnancy or delivery and has lasting injuries.

You may be eligible for compensation. These situations are often unpredictable, but your care team is responsible for monitoring situations that may become dangerous for you and your unborn child.

At Lopez McHugh LLP, our birth injury lawyers will fight for your right to compensation on behalf of your child. Injuries associated with fetal bradycardia often require extensive care that is lengthy and expensive.

Recovering your due compensation can help you to better meet the increased needs your child has as a result of physician negligence.

Contact us today to schedule a free case consultation.