Pediatric Heart Expert Forum
Fetal Heartbeat Skipping a Beat
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Questions in this forum are answered by pediatric cardiologists, cardiothoracic surgeons and anesthesiologists from The Children's Hospital of Philadelphia. This forum is for questions and support about pediatric heart problems, symptoms and topics such as heart murmurs, palpitations, fainting, chest pain, congenital heart defects (including management and intervention), fetal cardiology, adult congenital cardiology, arrhythmias and pre-participation athletic screening.

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Fetal Heartbeat Skipping a Beat

I am 17 weeks along in my second pregnancy.  I had no issues with my first.  This past visit, my OB noticed a skip in my unborn's heartbeat (four fast, normal beats & then a pause before continuing).  What could this mean exactly?  I have been researching online so many things, but they all keep mentioning fast or slow arrhythmias, but nothing regarding actually missing a beat.  Also, I am going in for a visit with a maternal fetal med doc this afternoon.  What should I expect from a good doctor?  Should they be performing a fetal echocardiography now?  Thank you so much for your input!
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Dear Jenny,

Without seeing your baby’s heart tracing, it’s hard to exactly know what is happening here.  However, it sounds as if you are describing isolated early heart beats (as opposed to sustained fast abnormal heart beats).   Examples of this would be premature atrial contractions (PACs) or premature ventricular contractions (PVCs).  These are quite common during the second trimester in the developing heart, and usually disappear by the third trimester or soon after birth.  They are also benign and don’t typically cause any problems.  It would be more concerning if there was sustained fast abnormal beats.  These can lead to the heart being overworked and create cause the heart function to decline with time.

In all, a good doctor should not only be knowledgeable, but also should be able to explain the situation to you so that you understand what is happening and answer your questions without leaving you to feel that you don’t know if your baby is safe, if there is a problem, etc.  Finally, a good doctor should know his or her limits of comfort with management.  At this time, the maternal-fetal medicine doctor (MFM) should be able to assess your baby’s heart appearance and function and to determine whether it’s normal, or not.  The MFM may also be able to determine the kind of abnormal heart rhythm that your baby is having.  If the MFM is not comfortable with what is seen, then referral to a fetal cardiologist would be appropriate.
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Thank you for your feedback.  It is greatly appreciated!

After I saw the MFM doc, the conclusion was too much caffeine.  I had given up caffeine when I found out I was pregnant.  However, this past weekend I drank about 6 cups of coffee over a two-day period.  Apparently, my baby is sensitive to caffeine, and had caused his hear to beat irregular.  Everything checked out wonderful with the baby.  The Dr was very helpful, and comforting.  They are going to monitor me throughout the pregnancy just to be safe.    
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