![]() ![]() She did not have any symptoms such as chest pain or breathlessness. When she was having her blood pressure measured at her 25-week midwifery visit, she had a resting heart rate of 110 beats per minute (bpm). She had no significant medical history and took no regular medications. The aim of this review is to provide a robust approach to the investigation and management of a persistent tachycardia in pregnancy.Ī 34-year-old woman was pregnant for the first time. 4 There are, therefore, conflicting pressures on clinicians caring for pregnant women to identify when a tachycardia may represent concerning pathology and identifying when tests are required, and not over-investigate otherwise well women who can safely be reassured without further investigation. 3 A key recommendation from the MBRRACE-UK (Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK) 2019 report is the importance of investigating ‘a persistent sinus tachycardia’ as this is considered a red flag, particularly when there are associated symptoms such as breathlessness or chest pain. Somewhere between these two levels therefore seems reasonable, but there is no clear threshold supported by recent data that can be applied to all pregnant women.Ĭardiac disease remains the largest single cause of indirect maternal deaths in the UK and there has been no significant change to maternal mortality rate from cardiac disease over the last few years. A threshold of 100 bpm will be too low for many women and result in unnecessary investigations, while 120 bpm is likely to be too high resulting in false reassurance and the potential to miss important diagnoses. ![]() With this recent evaluation of physiological parameters in pregnancy, an absolute value for the upper limit of normal in pregnancy is difficult to define. ![]() This showed that from 18 weeks of gestation, heart rates of over 100 bpm (and from 28 weeks, over 105 bpm) occurred in more than 10% of observations. However, recent data from a large-scale cohort study of healthy pregnancies in the UK suggest gestation-specific vital signs vary more widely than previously thought. 1 Traditionally, clinicians have been taught that physiological changes in pregnancy lead to an increase in resting maternal heart rate of 10 to 20 beats per minute (bpm) accepting slightly higher values in women with higher body mass index. If your doctor thinks you may have one of these conditions, your doctor may give you an EKG, a chest X-ray, or an echocardiogram (echo test) to diagnose what’s wrong.Analysis of obstetric early warning systems across the country has shown great variability in what are considered ‘normal’ vital signs in pregnancy.
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