Bridging gaps: The urgent call for cardio-obstetrics as a subspecialty in India

Justin Paul Gnanaraj1, Steaphen Anne Princy2

  • 1Institute of Cardiology, Madras Medical College and Rajiv Gandhi Government General Hospital, Park Town, Chennai, 600002, India; The Tamil Nadu Dr MGR Medical University, Guindy, Chennai, 600032, India.

Indian Heart Journal
|March 20, 2024
PubMed

Insights

Pregnancy with heart disease is rising in India, a leading cause of preventable maternal deaths. Addressing this requires national data, risk tools, guidelines, and cardio-obstetric teams.

Area of Science:

  • Cardiology and Obstetrics

Background:

  • Cardiovascular disease affects 1-4% of pregnancies, with increasing prevalence.
  • India significantly contributes to global maternal deaths, with cardiovascular disease a growing concern.
  • Cardiovascular disease in pregnancy is a leading cause of maternal mortality in developed nations and projected to rise in India.

Purpose of the Study:

  • To highlight the critical need for improved cardiovascular care in pregnancy in India.
  • To identify gaps in current Indian healthcare for pregnant women with heart disease.
  • To propose solutions for reducing preventable maternal mortality due to cardiovascular disease.

Main Methods:

  • This article reviews existing literature and identifies critical gaps in India's cardio-obstetric care.
  • It analyzes the challenges posed by the increasing prevalence of heart disease in pregnancy.
  • It proposes a framework for developing essential resources and programs.

Main Results:

  • India lacks crucial indigenous data, risk stratification tools, and management guidelines for cardio-obstetrics.
  • The concept of dedicated cardio-obstetric teams is underdeveloped.
  • Preventable maternal mortality from cardiovascular disease is a significant and growing issue.

Conclusions:

  • There is an urgent need to establish national registries and develop risk stratification tools.
  • Disseminating management guidelines and creating dedicated cardio-obstetric programs are essential.
  • Implementing these solutions can bridge gaps and improve maternal healthcare outcomes in India.

Related Concept Videos

Fetal Circulation01:14

Fetal Circulation

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
963
Imbalances in Cardiac Output01:26

Imbalances in Cardiac Output

The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
1.4K
Cardiovascular System Abnormal Findings II: Auscultation01:25

Cardiovascular System Abnormal Findings II: Auscultation

Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
141
Cardiovascular Drugs: Classification based on Therapeutic Indications01:18

Cardiovascular Drugs: Classification based on Therapeutic Indications

Cardiovascular diseases, encompassing a range of conditions, can significantly affect the heart's operations and the overall circulatory system. These conditions impair the heart's ability to pump blood, leading to a deficit in oxygen supply to crucial organs. Anomalies in the heart's electrical system, known as arrhythmias, can cause heartbeats to accelerate or slow down. Usually, heart rates increase during physical activity and decrease while resting or sleeping. However,...
2.8K
Overview of the Cardiovascular System01:14

Overview of the Cardiovascular System

The cardiovascular system is a vital transportation system in the body. It comprises the heart and blood vessels and facilitates the exchange of gases, nutrients, and waste products.
Heart
The heart is the central pump of the cardiovascular system that circulates blood throughout the body. It comprises two atria receiving the blood and two ventricles pumping blood out of the heart. Their rhythmic contractions, called heartbeats, ensure that blood flow remains continuous.
Blood Vessels
Blood...
4.5K
Primary Healthcare Services01:30

Primary Healthcare Services

Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...
1.4K