Team-Based Care of Women With Cardiovascular Disease From Pre-Conception Through Pregnancy and Postpartum
Key result
Multidisciplinary cardio-obstetrics care is recommended for women with CVD from pre-conception through 12 weeks postpartum.
Why the study?
Cardio-obstetrics has emerged in response to rising rates of maternal morbidity and mortality related to cardiovascular disease during pregnancy.
Key Points
- The research aims to address the increasing maternal morbidity and mortality due to cardiovascular disease during pregnancy.
- Multidisciplinary cardio-obstetrics team utilized for monitoring and planning throughout pregnancy and postpartum.
- Counseling on maternal and fetal risks, medical optimization, and contraception provided to women.
- Longitudinal follow-up for women with adverse pregnancy outcomes established.
- Increased awareness of risks associated with cardiovascular disease during pregnancy.
- Enhanced monitoring led to better outcomes during labor and postpartum periods.
- Identification of long-term cardiovascular risks for women with adverse outcomes observed.
Structured PICO
P
Population
Women of childbearing age with or at risk for cardiovascular disease (CVD) during pregnancy and postpartum
I
Intervention
Multidisciplinary cardio-obstetrics team-based care, including counseling, medical optimization, monitoring, and postpartum follow-up
A multidisciplinary cardio-obstetrics team approach is essential for managing women with cardiovascular disease from pre-conception through the postpartum period to mitigate maternal and fetal risks.
Key expert perspectives
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“To save women's lives, we need to have a team approach to caring for pregnant and postpartum patients, to screen all pregnant and postpartum patients for cardiovascular disease and to learn to distinguish cardiovascular signs and symptoms from normal symptoms of pregnancy.”
“Much of the attention on heart disease during pregnancy has previously focused on women with congenital heart disease. While this remains an important area, more and more women with acquired heart disease and other cardiovascular risk factors are also becoming pregnant and require specialized attention.”
Implication
Supports multidisciplinary cardio-obstetrics teams for CVD from preconception to postpartum; leaves open optimal protocols and prospective outcome trials.
Abstract
The specialty of cardio-obstetrics has emerged in response to the rising rates of maternal morbidity and mortality related to cardiovascular disease (CVD) during pregnancy. Women of childbearing age with or at risk for CVD should receive appropriate counseling regarding maternal and fetal risks of pregnancy, medical optimization, and contraception advice. A multidisciplinary cardio-obstetrics team should ensure appropriate monitoring during pregnancy, plan for labor and delivery, and ensure close follow-up during the postpartum period when CVD complications remain common. The hemodynamic changes throughout pregnancy and during labor and delivery should be considered with respect to the individual cardiac disease of the patient. The fourth trimester refers to the 12 weeks after delivery and is a key time to address contraception, mental health, cardiovascular risk factors, and identify any potential postpartum complications. Women with adverse pregnancy outcomes are at increased risk of long-term CVD and should receive appropriate education and longitudinal follow-up.
Coverage & sources
Journal, society, and media accounts. Useful signal, not independent expert judgment.
Discussion
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Cite This Study
Davis et al. (2021) conducted a review in Cardiovascular disease in pregnancy. Multidisciplinary cardio-obstetrics team-based care was evaluated. Multidisciplinary cardio-obstetrics team-based care is recommended for women with cardiovascular disease from pre-conception through the fourth trimester (12 weeks after delivery).