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Fajr Adil: Understanding Fetal Heartbeat on First Trimester Ultrasound
Jul 15, 2026, 14:05

Fajr Adil: Understanding Fetal Heartbeat on First Trimester Ultrasound

Fajr Adil, Sonographer at Al-Shakireen Hospital, shared a post on LinkedIn:

“First Trimester Ultrasound Series | Day 4

Fetal Cardiac Activity (Fetal Heartbeat)

Detection of fetal cardiac activity is one of the most reassuring findings in early pregnancy and an important indicator of embryonic viability.

Ultrasound Features

  • Usually detected by transvaginal ultrasound at 5.5–6 weeks of gestation.
  • Best assessed using M-mode ultrasound rather than spectral Doppler during the first trimester to minimize fetal ultrasound exposure.
  • Normal fetal heart rate increases rapidly in early pregnancy.

Normal Fetal Heart Rate

  • ~6 weeks: 90–110 bpm
  • 7–8 weeks: 120–170 bpm
  • 8–10 weeks: 150–180 bpm
  • After 10 weeks: usually 110–160 bpm

Clinical Pearl

If the CRL is ≥7 mm with no detectable cardiac activity on a high-quality transvaginal ultrasound, this is diagnostic of early pregnancy failure.

Learning Point

Always document:

  • Presence of fetal heartbeat.
  • Fetal heart rate (FHR).
  • Crown-Rump Length (CRL).
  • Gestational age.

Question for discussion:

Which ultrasound mode is recommended for measuring fetal heart rate during the first trimester: M-mode or Spectral Doppler?”

Fajr Adil

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