Heartrate Decels

Those of you in the PAML thread will already know this story, but I just wanted to put this out there to see what others think as I have a few lingering questions.

This morning at my 34 week checkup, the Dr was concerned about bubby's HR decelerating while he was checking with the doppler. I knew something was wrong when he put down the little 'radio' looking part of it on the bed beside me, and held my wrist to check my pulse. He'd never done this before, so I knew something was going on.

After a good 5 mins of listening and having a great deal of trouble getting bubs to be still enough to hear the hb properly, he decided to send me to the hospital for a CTG. I drove myself to the hospital STAT, and was relieved when the monitoring showed no problems whatsoever. I had no contractions, no decels.. and plenty of movement from bubby. The nurse said everything looked 'perfect' and my BP was also nice and normal.

So what was the problem this morning then? I left with no answers as to what might have caused the decels......... and am wondering if my GP was wrong? (not that I have any problem with him sending me to be checked out JUST IN CASE) I did ask the nurse if I should do anything different and she said to pay attention to movements, and if I felt worried at all (very vague instructions there) to come back for some more monitoring.

I'd say your GP was wrong in the fact he was concerned bubs heart was having decelerations but definately right to sent you to the hospital for a CTG if he was concerned which obviously he was. You can't be to careful with these things.

The reason I say this is because bub was moving around at the time he was using the doppler which would make its heart rate accelerate not decelerate. I'd say he/she was having an active period making it hard to get an accurate sound of bub heartbeating because of the movements. Perhaps he was picking up a combination of both yours and bubs or bubs heart rate was actually alot high then its normal resting heart rate and when it did stop moving and its heartbeat returned to its normal level it gave the impression it was decelerating when in actual fact it was probably going fast then returning to baseline if that makes sense. The fact bub sounded/looked good on CTG and fetal movements sound good would give me reasurance things are going along smoothly despite the scare this morning. I too would just keep an eye/feel for your baby movements and if they reduce head back up for another CTG or scan to check placental flows. The first sign of a compromised baby is lack or reduction of his/her movements.

I shouldn't say your GP was wrong. He did the right thing by referring you elsewhere I should have said he perhaps thought bubs heartrate was decelerating when it wasn't. Bubs can have a decel here or there but they shouldn't be regular or prolonged.

Thanks, Mildez. I am leaning towards agreeing with you there. The CTG would be way more accurate than the GP looking at his watch and holding my wrist, while listening to the doppler etc......

Ikwym though. He seems to have erred on the side of caution, which is a good thing. I guess the main thing I'm feeling bad about is getting this far without really worrying much at all............... only to have a bit of a scare and now feeling rather paranoid. But that's nobody's fault. Thanks for your reply :)

Were you lying on your back? I remember a couple of times my midwife checked the heart rate was not so good but when I shifted to my side it came good...

I was on my back, yes. But that's the way we've done it every time and never had any issues..... I was actually going to suggest that I shift to my side to encourage bubs to get into a better position for him to listen.

Yeah, I don't know. It was usually fine for me too, but sometimes lying that way can affect blood flow so maybe it was a factor. As Mildez said, the fact that all was good on the CTG is very reassuring.
All the best for the rest of your pregnancy.

I would say it was quite possible that your GP could hear something was a bit different but using the doppler meant he couldn't hear or track it well enough, and couldn't monitor for long enough to see if was an one off blip or an ongoing thing, so he send you to hospital where they could do more accurate tracking and get better information about the HB. So I wouldn't necessarily say he was wrong, just may not have had the tools available to assess it well enough so sent you where they did have the tools available. Glad to hear it was all good :)