Cardiovascular System - Heart Rate Development

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Introduction

Heart rate (beats / minute) is a measurement that can be made from early in development (when the heart first starts) through embryonic and fetal stages into labor and birth. It is a common clinical diagnostic tool, but data can be variable between countries and institutions.

Early ultrasonographic measurement of embryonic heart rate (EHR) shows a steady increase from Stage 9-10 (75 beats/minute) to Stage 18 (130 beats/minute) and on to Stage 20, following which a gradual decrease in EHR occurs (More? Embryonic Heart Rate). This increase correlates with heart development and a low EHR is used as an indicator of developmental failure and likely abortion. Late stethoscope measurements of fetal heart rate can monitor fetal stress and identifies the characteristic "lub-dub" heart valve sounds.


Cardiovascular Links: Introduction | Heart Tutorial | Lecture - Early Vascular | Lecture - Heart | Movies | Heart | Coronary Circulation | Heart Valve | Heart Rate | Circulation | Blood | Blood Vessel | Blood Vessel Histology | Cardiac Muscle Histology | Lymphatic | Ductus Venosus | Spleen | Stage 22 | Abnormalities | OMIM | 2012 ECHO Meeting | 2016 Cardiac Review | Category:Cardiovascular
Historic Embryology - Cardiovascular 
1902 Vena cava inferior | 1905 Brain Blood Vessels | 1909 Cervical Veins | 1912 Heart | 1912 Human Heart | 1914 Earliest Blood-Vessels | 1915 Congenital Cardiac Disease | 1915 Dura Venous Sinuses | 1916 Pars Membranacea Septi | 1919 Lower Limb Arteries | 1921 Human Brain Vascular | 1921 Spleen | 1922 Aortic-Arch System | 1922 Pig Forelimb Arteries | 1922 Chicken Pulmonary | 1923 Head Subcutaneous Plexus | 1925 Venous Development | 1928 Heart Blood Flow | 1935 Aorta | 1935 Venous valves | 1938 Pars Membranacea Septi | 1938 Foramen Ovale | 1939 Atrio-Ventricular Valves | 1940 Vena cava inferior | 1940 Early Hematopoiesis | 1942 Truncus and Conus Partitioning | Ziegler Heart Models | 1951 Heart Movie | 1954 Week 9 Heart | 1957 Cranial venous system | 1959 Brain Arterial Anastomoses | Historic Embryology Papers | 2012 ECHO Meeting | 2016 Cardiac Review | Historic Disclaimer

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Chicken embryo heart beat. Normal Chick Heart Movie

Some Recent Findings

  • Antenatal cardiotocography for fetal assessment[1] "Cardiotocography (CTG) is a continuous recording of the fetal heart rate obtained via an ultrasound transducer placed on the mother's abdomen. CTG is widely used in pregnancy as a method of assessing fetal well-being, predominantly in pregnancies with increased risk of complications. ...There is no clear evidence that antenatal CTG improves perinatal outcome, but further studies focusing on the use of computerised CTG in specific populations of women with increased risk of complications are warranted."
  • Normal Ranges of Embryonic Length, Embryonic Heart Rate, Gestational Sac Diameter and Yolk Sac Diameter at 6-10 Weeks [2] "We examined 4,698 singleton pregnancies with ultrasound measurements of CRL, HR, GSD and YSD at 6-10 weeks and CRL at 11-13 weeks resulting in the live birth after 36 weeks of phenotypically normal neonates with birth weight above the 5th centile. Gestational age was derived from CRL at the 11- to 13-week scan using the formula of Robinson and Fleming."

Textbooks

  • Human Embryology (2nd ed.) Larson Ch7 p151-188 Heart
  • The Developing Human: Clinically Oriented Embryology (6th ed.) Moore and Persaud Ch14: p304-349
  • Before we Are Born (5th ed.) Moore and Persaud Ch12; p241-254
  • Essentials of Human Embryology Larson Ch7 p97-122 Heart
  • Human Embryology Fitzgerald and Fitzgerald Ch13-17: p77-111

Embryonic Heart Rate

In a 1996 study normal successful human gestations were defined by EHR criteria at different early embryonic (34-56 days from last menstrual period) developmental stages (at the earliest stages when embryo length is difficult to measure gestational sac diameters are included). [3]

  • Stage 9-10 2 mm embryo (gestational sac diameter of 20 mm) EHR at least 75 beats / minute
  • Stage 11-12 5 mm embryo (gestational sac diameter of 30 mm) EHR at least 100 beats / minute
  • Stage 16 10 mm embryo EHR at least 120 beats / minute
  • Stage 18 15 mm embryo EHR at least 130 beats / minute

Fetal Heart Rate

Week 15 (GA week 17) Fetal Heart Rate audio recording of human embryo heart sounds Fetal Heart Sounds



Ultrasound Measurement

This movie is a realtime ultrasound recording of the week 12 fetus. The bottom window shows doppler analysis to measure the fetal heart rate.


Links: Quicktime | Flash

References

  1. Rosalie M Grivell, Zarko Alfirevic, Gillian M L Gyte, Declan Devane Antenatal cardiotocography for fetal assessment. Cochrane Database Syst Rev: 2012, 12;CD007863 PubMed 23235650
  2. George I Papaioannou, Argyro Syngelaki, Leona C Y Poon, Jackie A Ross, Kypros H Nicolaides Normal ranges of embryonic length, embryonic heart rate, gestational sac diameter and yolk sac diameter at 6-10 weeks. Fetal. Diagn. Ther.: 2010, 28(4);207-19 PubMed 20847544
  3. C B Coulam, S Britten, D M Soenksen Early (34-56 days from last menstrual period) ultrasonographic measurements in normal pregnancies. Hum. Reprod.: 1996, 11(8);1771-4 PubMed 8921130

Reviews

Janette F Strasburger, Ronald T Wakai Fetal cardiac arrhythmia detection and in utero therapy. Nat Rev Cardiol: 2010, 7(5);277-90 PubMed 20418904

Laura Bennet, Alistair Jan Gunn The fetal heart rate response to hypoxia: insights from animal models. Clin Perinatol: 2009, 36(3);655-72 PubMed 19732619

Jonathan T Butcher, Roger R Markwald Valvulogenesis: the moving target. Philos. Trans. R. Soc. Lond., B, Biol. Sci.: 2007, 362(1484);1489-503 PubMed 17569640


Articles

Jason N Hashima, Antonio E Frias, Leah Bernard, Eliot R Spindel, Theodore R Hobbs, Juha Rasanen Fetal ventricular diastolic filling characteristics in a primate model: the role of fetal heart rate and pulmonary vascular impedance. Reprod Sci: 2010, 17(8);760-6 PubMed 20595708

Young-Sun Park, Seung-Kwon Koh, Jeong-Kyu Hoh, Moon-Il Park Difference of fetal heart rate accelerations based on 10 and 15 beats per minute. J. Obstet. Gynaecol. Res.: 2010, 36(2);291-5 PubMed 20492379


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Cite this page: Hill, M.A. 2017 Embryology Cardiovascular System - Heart Rate Development. Retrieved October 22, 2017, from https://embryology.med.unsw.edu.au/embryology/index.php/Cardiovascular_System_-_Heart_Rate_Development

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© Dr Mark Hill 2017, UNSW Embryology ISBN: 978 0 7334 2609 4 - UNSW CRICOS Provider Code No. 00098G