April 20, 2026JACC Heart Failure
Cardio-Obstetrics and Heart Failure
Key result
Multidisciplinary cardio-obstetrics teams crucially manage pregnant women with HF through preconception counseling and medication safety.
Why the study?
Heart failure and cardiomyopathy are significant contributors to pregnancy-related deaths as maternal morbidity and mortality have increased, requiring multidisciplinary cardio-obstetrics management.
Design
Review
Authors
Discussion
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Member takes
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
MMMichelle M. KittlesonDirector of postgraduate medical education, Cedars-Sinai
“We know that we do not do a great job caring for pregnant individuals across the world, especially in the U.S. Maternal mortality continues to rise and that is particularly true for women with CVD, which accounts for more than one-third of pregnancy-related deaths. Women with a cardiomyopathy have a greater risk for an adverse cardiac event, including in-hospital mortality — fourfold greater if you have a cardiomyopathy event compared with other types of CVD. This is a huge problem.”
“Expert preconception counseling and appropriate risk stratification are necessary to provide individuals with the education and data needed for shared decision-making regarding the safety of pregnancy and potential outcomes.”
Implication
Prioritizes multidisciplinary teams and preconception counseling to curb rising HF maternal mortality; leaves open optimal protocols for LVAD/transplant cases.
Key Points
- The aim is to explore the impact of heart conditions on pregnancy and the importance of multidisciplinary management.
- Discusses preconception counseling for women with heart conditions.
- Explores risk stratification and management strategies for heart failure in pregnancy and postpartum.
- Reviews the safety of heart failure medications during pregnancy and considerations for women with advanced heart failure.
- Highlighting the rising rates of maternal morbidity and mortality related to heart failure.
- Emphasizing the unique management needs for women on left ventricular assist devices or post-transplant.
- Identifying critical hemodynamic changes that can unmask pre-existing conditions during pregnancy.
Structured PICO
P
Population
Pregnant individuals with pre-existing heart failure, 'pre-heart failure', peripartum cardiomyopathy, left ventricular assist device support, or prior heart transplantation.
I
Intervention
Multidisciplinary cardio-obstetrics management, preconception counseling, risk stratification, and heart failure medications.
A multidisciplinary cardio-obstetrics approach is essential for optimizing maternal and fetal outcomes in pregnant women with heart failure, including those with advanced therapies.
Coverage & sources
Journal, society, and media accounts. Useful signal, not independent expert judgment.
Cite This Study
DeFilippis et al. (2023) conducted a review in Heart failure and cardiomyopathy in pregnancy. This review outlines the crucial role of multidisciplinary cardio-obstetrics teams in managing pregnant women with heart failure, including preconception counseling and medication safety.