Normal Fetal Heart Rate

How does it work?

Understanding how to use the Normal Fetal Heart Rate Chart is simple. Here's a quick guide:

Step 1: Download our template

Start by getting our easy-to-use Printable Normal Fetal Heart Rate Chart. It's made to make tracking fetal heart rate a breeze, and keeping a copy at hand will help you record readings quickly and interpret them accurately.

Step 2: Explain to the parents how to use the chart

Tell the parents why the chart matters and how to use it. Break it down step by step so they know exactly what to do and what the chart’s columns and rows mean.

Step 3: Take fetal heart rate

Measure fetal heart rate correctly. This step is a whole process in itself. Take a look at this quick overview:

1. Gather the essentials: Prepare a fetal Doppler device, a gel for better sound conduction, and a recording tool, such as our downloadable template or a notepad.
2. Prepare the mother: Ensure the mother is comfortable, usually lying on her back. Apply a small amount of gel to the mother's abdomen to enhance the Doppler's performance.
3. Locate the heartbeat: Place the Doppler on the mother's abdomen, moving it gently until you detect the rhythmic thumping sound—the fetal heart rate.
4. Count the beats: Use a timer and count the beats you hear in one minute. This gives you the fetal heart rate's beats per minute (BPM).
5. Record the data: Note the BPM and any additional observations, such as the date and time. This information is crucial for ongoing monitoring.

Step 4: Compare against the chart

Check the chart after getting the fetal heart rate. There are different normal fetal heart rate charts by week for different fetus genders. See where it falls on the appropriate chart, and evaluate what this means for the mother’s and the fetus’s health.

Step 5: Record findings and discuss with the parents

Write down the fetal heart rate and anything meaningful in a log. Keeping detailed health records helps track progress and spot trends. Then, discuss it openly with patients. Answer questions and address concerns. These should also be addressed if you recommend any lifestyle, diet, or medication adjustments. This teamwork ensures everyone is on the same page about the baby's health.

When would you use this chart?

The Normal Fetal Heart Rate Chart caters to various scenarios and healthcare needs. Tailored to aid relevant practitioners, this chart can be used in several contexts:

Routine Checkups

Monitoring fetal heart rate consistently throughout the gestational period lets you establish a baseline and swiftly identify any deviations that may signal potential concerns.

Monitoring Maternal Health

You can use the Normal Fetal Heart Rate Chart when the mother reports feeling unwell or has any health-related issues. It provides a quick and reliable method for assessing the fetus's well-being.

Lifestyle Adjustments

When mothers are making lifestyle adjustments, such as dietary changes, exercise routines, or stress management, the Normal Fetal Heart Rate Chart offers a practical means to gauge the impact on fetal well-being.

Medication Changes

Sometimes, there is a need for adjustments in medication during pregnancy. The Normal Fetal Heart Rate Chart provides valuable insights into how the fetus responds to medication changes.

High-Risk Pregnancies

For pregnancies deemed high-risk due to various factors, continuous monitoring with the Normal Fetal Heart Rate Chart is imperative. It allows for proactive management and timely interventions, reducing potential risks and optimizing outcomes for both mother and child.

What do the results mean?

Interpreting the results from the Free Normal Fetal Heart Rate Chart is vital for understanding the well-being of the developing fetus. The chart provides percentiles at different gestational weeks, giving you a comprehensive view of normal fetal heart rate ranges. Here's a breakdown of what the percentiles signify:

• 2.5th Percentile: Represents the lower limit of the normal range. Fetal heart rates below this may warrant closer monitoring for potential concerns.
• 5th Percentile: Still within the normal range but on the lower side. Monitoring and additional attention may be necessary.
• 10th Percentile: A slightly broader normal range. Fetal heart rates falling here are generally considered normal.
• 25th Percentile: The lower end of the typical range. Fetal heart rates in this percentile are generally within the normal spectrum.
• Mean: The average or midpoint of the normal range. Falling close to this value indicates a typical fetal heart rate.
• 75th Percentile: The higher end of the normal range. Fetal heart rates here are generally considered normal.
• 90th Percentile: A slightly broader normal range on the higher side. Fetal heart rates in this percentile are generally considered normal.
• 95th Percentile: Represents the upper limit of the normal range. Fetal heart rates in this percentile are generally considered within the normal spectrum but may be a signal for closer monitoring due to a slightly increased likelihood of variations.
• 97.5th Percentile: The uppermost limit of the normal range. Fetal heart rates in this percentile are still considered within the normal spectrum. However, continuous monitoring is highly recommended to ensure that any potential variations are promptly identified and addressed.

Research and evidence

A comprehensive investigation from the Safe Passage Study led by Shuffrey et al. established normative values for heart rate patterns in healthy fetuses. Examining 1,655 fetuses at three different gestational time points (20–24 weeks, 28–32 weeks, and 34–38 weeks), the study revealed dynamic changes in fetal heart rate (FHR), heart rate variability (HRV), and movement.

FHR exhibited a decreasing trend, with males demonstrating significantly lower FHR than females in the later gestational periods. Notably, the study delved into the intricacies of the fetal state, uncovering that males had lower FHR only in the active fetal state during late gestation.

Furthermore, the research highlighted the increased heart rate variability over gestation, with state-specific observations indicating higher movement during the active fetal state. The coupling between FHR and fetal movements was state-dependent, reaching its peak in the quiet fetal state. The longitudinal study provided valuable insights into sex-related differences in FHR, emphasizing its relevance for understanding fetal autonomic system development.

This extensive study, part of the Prenatal Alcohol and SIDS and Stillbirth (PASS) Network, not only contributes essential normative data but also sets the stage for future analyses within the network. The presented fetal assessment measures and normative values serve as valuable references for clinicians and researchers, offering insights into fetal brain development and potential markers for identifying risks of stillbirth, SIDS, or neurodevelopmental disorders.

In addition, a groundbreaking study by Frasch et al. sheds light on intrinsic fetal heart rate variability (iHRV) and its susceptibility to the effects of chronic fetal hypoxia. The study, conducted on chronically catheterized ewes with male singleton fetuses, exposed subjects to either normoxia or hypoxia during the last third of gestation.

Isolated hearts from hypoxic pregnancies exhibited notable alterations in iHRV measures, with approximately 4-fold increases in the Grid transformation and AND similarity index and a 4-fold reduction in the scale-dependent Lyapunov exponent slope.

Moreover, a 2-fold reduction in Recurrence quantification analysis, percentage of laminarity, recurrences, and changes in maximum and average diagonal line showcased the intricate impact of chronic fetal hypoxia on iHRV. The study further unveiled correlations between iHRV measures and left ventricular end-diastolic pressure, underlining the physiological significance of these alterations.

This research pioneers the understanding that iHRV originates in fetal life and is significantly influenced by chronic fetal hypoxia, marking a crucial advancement in comprehending the intrinsic control of cardiac function during late gestation.

References

Frasch, M. G., Herry, C. L., Niu, Y., & Giussani, D. A. (2020). First evidence that intrinsic fetal heart rate variability exists and is affected by hypoxic pregnancy. The Journal of Physiology, 598(2), 249–263. https://doi.org/10.1113/jp278773

Ghi, T., Di Pasquo, E., Dall’Asta, A., Commare, A., Melandri, E., Casciaro, A., Fieni, S., & Frusca, T. (2020). Intrapartum fetal heart rate between 150 and 160 bpm at or after 40 weeks and labor outcome. Acta Obstetricia et Gynecologica Scandinavica, 100(3), 548–554. https://doi.org/10.1111/aogs.14024

John Hopkins Medicine. (2019). Fetal heart monitoring. John Hopkins Medicine. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/fetal-heart-monitoring

Jones, B. (2023, June 11). What’s a Normal Fetal Heart Rate During Pregnancy? (R. White, Ed.). Verywell Health. https://www.verywellhealth.com/normal-fetal-heart-rate-5216868#toc-what-is-an-abnormal-fetal-heart-rate

Malachi, R. (2019, April 2). Fetal heartbeat: Week-by-week chart and methods used to monitor it (R. et al. Das, Eds.). MomJunction. https://www.momjunction.com/articles/fetal-heartbeat_00475982/

Pildner von Steinburg, S., Boulesteix, A.-L., Lederer, C., Grunow, S., Schiermeier, S., Hatzmann, W., Schneider, K.-T. M., & Daumer, M. (2013). What is the “normal” fetal heart rate?. PeerJ, 1(82). https://doi.org/10.7717/peerj.82

Shuffrey, L. C., Myers, M. M., Odendaal, H. J., Elliott, A. J., du Plessis, C., Groenewald, C., Burd, L., Angal, J., Nugent, J. D., Isler, J. R., & Fifer, W. P. (2019). Fetal heart rate, heart rate variability, and heart rate/movement coupling in the safe passage study. Journal of Perinatology: Official Journal of the California Perinatal Association, 39(5), 608–618. https://doi.org/10.1038/s41372-019-0342-9

Valenti, O., Di Prima, F. A. F., Renda, E., Faraci, M., Hyseni, E., De Domenico, R., Monte, S., & Giorgio, E. (2011). Fetal cardiac function during the first trimester of pregnancy. Journal of Prenatal Medicine, 5(3), 59–62. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3279166/

Weiss, R. E. (2022, September 26). How to Determine If Your Baby’s Fetal Heart Rate Is Normal (B. Levine, Ed.). Verywell Family. https://www.verywellfamily.com/what-is-a-normal-fetal-heart-rate-2758733

Widnes, C., Flo, K., Wilsgaard, T., Kiserud, T., & Acharya, G. (2018). Sex differences in umbilical artery Doppler indices: A longitudinal study. Biology of Sex Differences, 9(1). https://doi.org/10.1186/s13293-018-0174-x