Assessment of Embryo Heart Rate in Early Pregnancy by Transvaginal Ultrasonography with Color and Pulsed Doppler

Revista Brasileira de Ginecologia e Obstetrícia 10/2000; 22(9):551-555. DOI: 10.1590/S0100-72032000000900003


Objetivos: avaliar a evolução da freqüência cardíaca embrio-fetal no primeiro trimestre da gestação e determinar sua curva de normalidade. Pacientes e Métodos: em estudo prospectivo foram avaliadas 206 pacientes com diagnóstico clínico e/ou ultra-sonográfico de gestação no primeiro trimestre, por meio de exame ultra-sonográfico transvaginal com Doppler colorido, utilizando-se equipamento da marca Aloka, modelo SSD-2000, com sonda transvaginal convexa na freqüência de 5,0 MHz, todos realizados por um mesmo examinador. Foi determinada a freqüência cardíaca embriofetal. As pacientes foram divididas em grupos de acordo com a idade gestacional, em intervalos de 0,5 semana a partir da 6ª semana de gestação. Foi avaliada a evolução da gestação mediante realização de exame ultra-sonográfico de rotina no final do 2º e 3º trimestre. Foram calculados as médias e desvios-padrão para cada idade gestacional avaliada. Resultados: foi possível determinar a curva de normalidade para a freqüência cardíaca embriofetal. A média da freqüência cardíaca embriofetal apresentou modificações com a evolução da idade gestacional, variando de 110 ± 14 bpm com 6,0 semanas a 150 ± 12 bpm com 14,0 semanas, compatíveis com as fases do desenvolvimento e maturação funcional cardíaca. Conclusões: a ultra-sonografia transvaginal com Doppler colorido tornou possível a avaliação cardiovascular da gestação inicial, sendo um método não-invasivo e inócuo para o embrião. Os valores determinados poderão ser utilizados em estudos futuros neste período gestacional.

14 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the significance of cardiac activity on endovaginal ultrasound in embryos up to 10 mm in size. Ninety-six women with positive urinary pregnancy tests had vaginal probe ultrasound examinations at the first clinical visit. All had discernible embryos between 1-10 mm in greatest length. The presence or absence of discernible cardiac activity was recorded. None of the subjects had any antecedent bleeding. All were available for follow-up until delivery or completion of a failed pregnancy. Seventy-four women had cardiac activity present at the initial study and 22 did not. Eighty-one delivered healthy newborns and 15 had early pregnancy failure. All embryos that ultimately proved normal showed cardiac activity by the time they were 4 mm in size. However, absence of detectable cardiac activity in embryos of 3 mm or less was still associated with a 41% continuation rate. Cardiac activity is present in normal embryos before it can be detected on ultrasound. There are variations in the type and frequency of ultrasound equipment, maternal anatomical characteristics (obesity, coexisting fibroids, uterine version), and in the visual acuity of observers. Nevertheless, we conclude that in our hands, the absence of cardiac activity in embryos measuring 4 mm or more is reliably associated with embryonic death. In contrast, the lack of cardiac activity in embryos of 3 mm or less is nondiagnostic and may warrant follow-up study in 3-5 days.
    Obstetrics and Gynecology 11/1992; 80(4):670-2. · 5.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Using a pulsed ultrasound technique, the human fetal heart rate was studied between 45 days and 15 weeks after the first day of the last menstrual period. The heart rate rose from a level of 123 beats per minute at 45 days to a peak of 177 beats per minute at 9 weeks, and then gradually fell to a value of 147 beats per minute at 15 weeks. In cases of threatened abortion the fetal heart rates were not statistically different from those in normal pregnancies. The changes in heart rate were correlated with the morphological and physiological changes which occur in the fetal heart during this period.
    The Journal of obstetrics and gynaecology of the British Commonwealth 10/1973; 80(9):805-9. DOI:10.1111/j.1471-0528.1973.tb11222.x
  • [Show abstract] [Hide abstract]
    ABSTRACT: Using a high-resolution real-time arc sector scanner, fetal cardiac activity was detected in ten normal intrauterine pregnancies, including one triplet gestation, between 41 and 43 days of gestation. Fetal heart rates ranged from 96 to 120 beats/min (mean 110) and were detected contiguous with the yolk sac as a tiny blinking, flashing, and/or rocking echo with a regular rhythm. The mean gestational sac fluid diameters ranged from 8 to 16 mm and the crown-rump lengths, when measurable, were less than 4 mm. The demonstration of early fetal cardiac activity in utero reduces parental anxiety and indicates a favorable prognosis in patients with threatened abortion, and virtually excludes the diagnosis of ectopic pregnancy.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 12/1984; 3(11):499-503. · 1.54 Impact Factor

Preview (3 Sources)

14 Reads
Available from