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Creating a Multidisciplinary Pregnancy Heart Team
Sarah Rae Easter1, Anne Marie Valente2, Katherine E Economy3
1Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA. seaster@bwh.harvard.edu.
Insights
Establishing a multidisciplinary Pregnancy Heart Team improves care for pregnant women with cardiovascular disease (CVD). This integrated approach aims to reduce maternal mortality and morbidity by focusing on risk stratification and comprehensive care.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Obstetrics
- Cardiovascular Disease in Pregnancy
Background:
- Cardiovascular disease (CVD) is a leading cause of maternal mortality.
- Maternal deaths from CVD are often linked to inadequate, risk-appropriate care.
- This review focuses on establishing specialized care teams for pregnant women with CVD.
Purpose of the Study:
- To outline considerations for creating a multidisciplinary team for pregnant women with CVD.
- To emphasize the importance of specialized care for cardiovascular conditions during pregnancy and postpartum.
- To highlight the need for risk-appropriate care in managing maternal CVD.
Main Methods:
- Review of existing guidelines and evidence regarding multidisciplinary care teams.
- Discussion of the composition and functions of a Pregnancy Heart Team.
- Focus on antepartum risk stratification, delivery planning, and preconception/postpartum care.
Main Results:
- Multidisciplinary teams improve outcomes for high-risk pregnancies.
- National guidelines recommend Pregnancy Heart Teams for pregnant women with CVD.
- These teams facilitate holistic care, cross-disciplinary education, and integrated management.
- Evidence suggests this approach can decrease severe maternal morbidity and mortality.
Conclusions:
- A Pregnancy Heart Team offers a structured approach to managing pregnant women with CVD.
- Integrated care, including risk stratification and comprehensive planning, is crucial.
- Further research is needed on cost-effectiveness and long-term cardiovascular health impacts.
Purpose Of Review:
Cardiovascular disease (CVD) is the leading cause of maternal death and cases of cardiovascular death are often associated with failure to provide timely risk-appropriate care. This review outlines considerations for creation of a team focused on the care of women with CVD during pregnancy and beyond.
Recent Findings:
Improved outcomes for women with complex medical or obstetric conditions managed by a multidisciplinary care team inspired national guidelines advising the creation of a Pregnancy Heart Team for women with CVD in pregnancy. The recommendations from the European Society of Cardiology provide general guidance for risk-appropriate care without elaborating on the details of these specialized care teams. A Pregnancy Heart Team led by providers from cardiology, maternal-fetal medicine, obstetrics, obstetric anesthesia, pharmacy, and nursing support a holistic approach to patient care while facilitating opportunities for cross-disciplinary education. This team should focus on frequent antepartum risk stratification, multidisciplinary delivery planning, and comprehensive preconception and postpartum care. Available evidence suggests that a consistent and integrated approach to care for women with CVD in pregnancy has the potential to decrease severe maternal morbidity and mortality. The cost-effectiveness of this approach and the impact of this comprehensive care model on a woman's long-term cardiovascular health warrant future study.
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