Is it possible to do an ECG during pregnancy and how?

What is ECG

Electrocardiography is a method of studying the electric fields generated during the work of the heart with subsequent recording of the results obtained on paper film.
The examination provides accurate information about the frequency and rhythm of the heartbeat, recording the speed of the electrical impulse.

When conducting a cardiogram, electrodes are attached to the patient's skin to obtain information using a special device that records the regularity of contractions.

Diagnosis records cardiac dysfunction, individual forms of arrhythmia and the presence of specific diseases associated with the functioning of the heart.

Pregnant women undergo electrocardiography at least twice during the entire gestation period if there are no problems with cardiac activity. If necessary, the procedure is performed more often.

Diagnostics are allowed for young children and developing fetuses to register their health status.

An ECG during early pregnancy is prescribed by a doctor to diagnose possible abnormalities and determine the correct treatment regimen.

When is an ecg prescribed for pregnant women?

Due to the fact that the process of bearing a child is associated with significant restructuring of the body, it is understandable why women are prescribed many tests and studies. One of the mandatory procedures is an ecg during pregnancy - in principle, every person knows how electrocardiography is done. At the same time, few of the fair sex are aware that in some cases it will have to be done several times, including in later stages. Very often, doctors prescribe a heart test during a difficult pregnancy, when there is a need for constant monitoring of the cardiovascular system. In addition, expectant mothers who have congenital or acquired cardiac dysfunction will have to undergo electrocardiography several times.

If in the first months of pregnancy myocardial diagnosis is carried out to determine the nature of the rhythm and determine existing disorders, then in the future the reason for taking a cardiogram may be:

• periodic or constant discomfort in the heart area;
• feeling of heaviness in the chest;
• oligohydramnios, serious toxicosis, gestosis, polyhydramnios and other complications associated with the growth and development of the child;
• increase or decrease in blood pressure;
• fainting or frequent dizziness.

Preparing for a cardiogram: about eating and drinking

Before starting diagnostics, you should pay attention to the following points:

• It is necessary to notify the doctor ahead of time about the medications you are taking. Ingredients in some medications may interfere with test results;
• before making a diagnosis, it is prohibited to apply cosmetic or medicinal creams to the skin surface due to the effect on conductivity;
• For the appointment, it is better to wear clothes that are easy to unbutton or take off;
• bracelets, pendants, chains and other jewelry from the neck and hands are removed in advance;
• drinking cold water is eliminated.

A number of common questions include: “Can I eat before an ECG?”
Eating is allowed two hours before the start of the procedure. Diagnostics on an empty stomach is not allowed, as this affects the results of the analysis.

Before performing an ECG, it is necessary to exclude physical activity.

Stages of the study

The examination procedure is completely painless and takes minimal time. It is important to properly prepare for the study so that nothing affects the results. The main point is to attach special electrodes to the human body. It is these devices that will read the pulses for the cardiogram.

1. Immediately before the study, you should not perform any physical activity; you should not even climb stairs. It is important to come to the ECG in a rested state, it is best if you choose the morning or evening time after a day off. Even general fatigue of the body can significantly distort the results of the study, providing indicators worse than they actually are.
2. You cannot eat more than 2 hours before the test. This is the most optimal time, since it is not recommended to do an ECG on a full or completely empty stomach, especially during pregnancy. These indicators can also affect the result.
3. The procedure itself is carried out in a horizontal position, you need to undress to the waist and bare your ankles. Special electrodes with suction cups will be attached to the chest, and plates to the ankles. Before installing the devices, the skin is disinfected with a special liquid.
4. It is important to be in a relaxed and calm state during the procedure. Emotional stress, excitement and other similar factors have a direct impact on the performance of the device.
5. The result of the study is usually released immediately after the procedure is completed. A cardiologist will be able to evaluate the cardiogram and identify abnormalities if they exist.

When deciphering the result, the most important thing is to study the heartbeat, its frequency and character. The norm is considered to be a result of 60 to 80 heart beats per minute, and the rhythm should be smooth without interruptions. Any deviations require the use of necessary measures, lifestyle changes, treatment, adherence to sleep and wakefulness.

How to do an ECG for pregnant women

This process for pregnant women is identical to the usual electrocardiography procedure. The patient is asked to lie down on the couch.

The doctor takes time for rest and relaxation - worries before the upcoming diagnosis affect future results.

Before fixing special equipment to individual parts of the body, the skin is degreased using alcohol or gel to conduct the impulse.

The doctor places four multi-colored electrodes in the chest area. Plates are attached to the wrists and shins:

• red and yellow electrodes are alternately installed on the right and left hands in accordance with medical standards;
• Electrodes of two colors are placed on the lower limbs: green on the left, black on the right. The black electrode is used to prevent electric shock in the event of sudden failure of special equipment.

Images of cardiac impulses are displayed on paper film. When carrying out the procedure, you must remain calm, come cheerful and rested.

Time: 10-15 minutes.

ECG during pregnancy: is it possible to do it and how is an ECG done? Decoding the results

People interested in the question of whether it is possible for pregnant women to have an ECG, and how harmful an ECG is during pregnancy, probably do not realize that during the period of gestation, every woman undergoes an ECG examination at least twice.
Moreover, an electrocardiogram of the heart is done both for the expectant mother and for the child. For this purpose, electrodes are used that are fixed to the skin. Heart activity signals (heart rate, rhythm, size and shape of peaks, impulse speed) are recorded on paper tape. In other words, an ECG records the electrical activity of the heart. This is how an ECG is usually done during pregnancy: if a woman has no contraindications, then a cardiogram is taken when registering and when going on maternity leave. Having understood that pregnant women can have an ECG, let’s find out why it is needed.

Using an ECG, abnormalities in the functioning of the heart can be detected, and if they are found, the woman is recommended to visit a cardiologist.

The most common problems are various forms of arrhythmia, impulse blockade and problems with myocardial functioning. A poor ECG during pregnancy may indicate gestosis - functional disorders leading to complications during pregnancy.

During a normal pregnancy, a normal ECG will be recorded in pregnant women. But changes can still occur, for example, related to the displacement of the heart and diaphragm in the chest. If the ECG during pregnancy is normal, then its readings will be sinus.

• When registering a pregnant woman, she needs to undergo many tests, including an ECG, to check the readiness of her body to bear a fetus.
• If the expectant mother often experiences sudden surges in pressure in both directions, then it is necessary to check the heart with an unscheduled ECG.
• Pain in the heart area definitely requires an electrocardiogram.
• If complications arise during pregnancy, such as oligohydramnios or polyhydramnios, severe gestosis or toxicosis, then cardiograms are also taken repeatedly.

Do not be afraid of unscheduled ECG studies, since they are completely safe for both the mother and the unborn baby.

The peculiarities of the procedure for taking ECGs in pregnant women are that they simply do not exist - everything is the same as in other subjects. Let us repeat once again that the procedure is absolutely painless. Up to 12 graphs are drawn on the cardiograph tape, reflecting various cardiac impulses. How is an ECG done for pregnant women? Electrodes are installed on suction cups in the heart area, and in the form of plates on the wrists and shins.

• You need to enter the office without exhausting climbing stairs and other fatigue, because general fatigue noticeably distorts the results of the cardiogram.
• Before the examination, you need to eat no later than two hours, then there will be no severe hunger or a full stomach, because both of these conditions also negatively affect the examination.
• The procedure is carried out in a lying position so that the subject is relaxed and her heart works without tension. You'll have to undress to the waist and bare your ankles. Electrodes are fixed to the exposed areas to detect cardiac impulses.

This type of examination is considered perhaps the safest in cardiac diagnostics. It is not capable of negatively affecting the body, since it has no effect on tissues and organs. Here the human electric field emitted by the heart is simply recorded.

Such a study can be carried out many times, even without intervals, if necessary. In other words, there are absolutely no contraindications for an ECG examination. Knowing how an ECG is done during pregnancy, it should be added that it is also acceptable for very young children, as well as seriously ill patients.

This study cannot affect the composition of milk, so there is no need to worry about this either.

The fetal examination is called CTG and is most often carried out in the last months or just before birth. Sometimes it is done at earlier stages in order to study the condition of the fetus. During CHT, fetal movements, its heart rate, and the frequency of contractions in the run-up to labor are measured. This procedure is also absolutely safe for the mother and her child.

Effect of ECG on the fetus

An important question for an expectant mother is: “is it possible to do an ECG during pregnancy?” and “what impact does it have on the baby?”

It is known that ECG is harmful to the child and is strictly prohibited for pregnant women. However, this judgment has been refuted by doctors - a cardiogram is recognized as a safe, painless procedure and cannot have a detrimental effect on the developing embryo.

The impulses are not reflected negatively on the placenta, organs and tissues, or on the milk of the expectant mother.

The procedure has no contraindications.

Description of electrocardiography

During contraction, the heart generates electrical impulses that 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 cholesterol or high blood pressure).

Your doctor may also recommend an ECG if you experience adverse symptoms such as chest pain, shortness of breath, dizziness, fainting, or fast or irregular heartbeat.

An ECG is a safe and non-invasive procedure without any significant risks or 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 should also be notified of any allergic reactions to 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 can provide 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 the 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 diagnostic 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.
• Fetal ECG (CTG, cardiotocography) - performed in the third trimester of pregnancy, most often in 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 transmitted with the pregnant woman’s card 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.
• Monitor for cardiac abnormalities due to abnormal chemical reactions (electrolyte imbalances) that control cardiac activity.
• 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.

Diseases identified during diagnosis

The cardiogram detects the following diseases:

• arrhythmia;
• tachycardia;
• bradycaria;
• blockade;
• hypertrophy;
• pericarditis;
• myocarditis.

It is possible to detect low levels of potassium and calcium in the blood, the causes of symptoms of difficulty breathing, dizziness, rapid heartbeat, and pathology of the heart muscles.

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 place) complexes (extrasystoles);
• acute or chronic deficiency of coronary blood flow (ischemia, angina, heart attack);
• disruption of electrical impulses (blockade);
• 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

Norms and acceptable features of the cardiogram

Interpretation of ECG in pregnant women during the gestational period is associated with the physiological characteristics of the body. So, the norm for contraction frequency readings is 60-80 beats/min.

During pregnancy, due to increased blood circulation and changes in hormonal levels, the quantitative level of heart rate may increase, but ideally should not exceed 80 contractions.

The position of the heart is expressed by axis values. Normal value: 30-70, but during pregnancy a level from 70 to 90 is acceptable.

The location of the diaphragm is likely to change; the movement occurs along the sagittal axis. After the baby is born, the previous values ​​are restored.

During pregnancy, the presence of other extrasystoles (contractions of the heart muscles) is permissible, since changes occur in certain parts of the heart.

Establishment of atrial or ventricular rhythm must be further examined by a doctor.

Before finding and recording possible pathologies with a negative cardiogram result, diagnostics are performed several times.

The doctor determines the differences between the two results, and if deviations from the norm are found, the patient is prescribed an ultrasound of the heart to identify anatomical disorders.

In the conclusion, the nature of the heart rhythm, heart rate and EOS (electrical axis of the heart) are indicated and the disorders found during the study are described.

The diagnosis is established based on the results of the cardiogram, taking into account the symptoms and characteristic signs of a particular disease, and the patient’s complaints.

Decoding the information received about the patient’s condition takes from 5 to 10 minutes.

Normal fetal ECG during pregnancy

As a result of the examination, the following indicators of fetal cardiac activity are identified and assessed:

• Basal rhythm is the number of fetal heartbeats per minute (normal 120-160 beats per minute).
• Heart rate variability is the difference between the number of heartbeats at rest and during activity (the norm is 6-20 beats).
• Accelerations - acceleration of heart rate due to external influence (norm 2 or more during a 20-minute examination)
• Decelerations - slowing down of the fetal heartbeat when its head is compressed (normally should be absent)

Read the article by an obstetrician-gynecologist about the norms and deviations in the fetal heartbeat by week!

ECG of the fetus during pregnancy: deciphering deviations

The following ECG readings of a child during pregnancy are considered pathological:

• Monotonous (silent) CTG is the absence of accelerations and decelerations of the rhythm, although the basal rhythm may be normal.
• Sinusoidal CTG - detected when there is low variability in fetal heart rate. This is a very unfavorable type of CTG, indicating severe fetal hypoxia.
• Lambda rhythm is an alternation of accelerations and subsequent decelerations. This type of CTG occurs with umbilical cord compression of various etiologies.

Fetal ECG is widely used in obstetrics as the most informative and safe examination.

Fetal ECG is also called cardiotocography or CTG. A detailed article about CTG during pregnancy from an obstetrician-gynecologist!

Svetlana Alexandrova, cardiologist, especially for Mirmam.pro

Disadvantages and Limitations

The cardiogram, along with other diagnostic methods, has its own shortcomings. Eg:

• some diseases can be displayed as normal values ​​when displaying the result;
• this technique is static and does not indicate heart problems if there are no symptoms;
• pathological changes are observed in specific diseases. In such cases, an additional examination is prescribed to fix an accurate diagnosis.

Before attending the procedure, it is important to consult with the gynecologist leading the pregnancy and specialists.

Based on the diagnosis and tests obtained, the doctor will prescribe a competent treatment regimen and draw up a labor management plan.

Decoding indicators

Without special education, it is better not to attempt to independently decipher a cardiogram. The graph shown on the tape is assessed by the doctor individually. It is difficult to understand the indicators without the help of a doctor.

Normally, an ECG in a pregnant woman may display:

• ventricular and atrial ectopic rhythms;
• T-wave (interval) or small Q-wave in lead III;
• depression in ST segment indicators;
• shortening the PR interval;
• in the lateral or downward direction, T wave inversion;
• QRS is shifted to the left;
• the cardiac electrical axis deviates to the left.

If the gynecologist detects abnormalities, then a repeat diagnosis is prescribed. Quite often, upon repeated examination, the results correspond to the norm, since the cause of violations can even be the uncomfortable position of the pregnant woman at the time of the procedure.

Normal for mother and fetus

Normally, a woman's sinus heart rate should be 60–90 beats/min. The electrical axis has an angle of 30–90 degrees. Regarding the heart rate, deviations within 100 beats/min are allowed. if the indicator is higher, then we are talking about tachycardia.

Normally, a woman should have no signs of conduction disturbances, heart rhythm disturbances, myocardial muscle hypertrophy, ischemia or dystrophic changes. If the symptoms of the pathological condition are pronounced, measures are taken for stabilization or delivery.

In the fetus, the normal basal heart rate will be 110–160 beats/min. Various factors can affect a baby's heartbeat, so 10-minute averages are calculated. If the norm is significantly exceeded, additional diagnostics are performed.