Related Experiment Video
Updated: Jun 23, 2025
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
Reach and effectiveness of a non-university cardio-obstetrics program
Retu Saxena1,2, Gretchen Benson1, Abbey C Sidebottom3
1Minneapolis Heart Institute Foundation, Minneapolis, MN, USA.
Insights
Multidisciplinary cardiovascular obstetric programs (CVOB) improve care for pregnant patients with heart disease. These programs increase cardiovascular testing, specialist monitoring, and medication management for higher-risk pregnancies.
Area of Science:
- Cardiology
- Obstetrics
- Maternal-Fetal Medicine
- Public Health
Background:
- Current guidelines advocate for multidisciplinary cardiovascular obstetric programs (CVOB) to manage pregnant individuals with complex cardiovascular conditions.
- However, there is limited evaluation of these programs, which are predominantly offered at university-based medical centers.
Purpose of the Study:
- To evaluate the impact of a CVOB program implemented in a non-university health system.
- To compare patient characteristics and care received before and after the program's establishment.
Main Methods:
- A retrospective cohort study compared 102 patients managed by a CVOB team (2018-2019) with 102 matched controls seen by cardiology prior to the program (2016-2017).
- Matching was based on the modified World Health Organization (mWHO) risk category.
Main Results:
- CVOB patients represented a more ethnically diverse population with higher cardiovascular risk (mWHO ≥ II-III: 57% vs 17%).
- CVOB patients received more cardiology tests (median 8 vs 5), telemetry care (32% vs 19%), and perinatology visits (median 8 vs 2).
- Vaginal delivery patients in the CVOB group had a slightly longer length of stay (median 2.66 vs 2.13 days).
Conclusions:
- Implementing a CVOB program successfully engaged a more diverse patient population.
- The CVOB program enhanced the level of care, evidenced by increased cardiovascular testing, monitoring, specialist involvement, and appropriate medication use during pregnancy.
Background:
Current guidelines recommend multidisciplinary cardiovascular obstetric programs (CVOB) to manage complex pregnant patients with cardiovascular disease. Minimal evaluation of these programs exists, with most of these programs offered at university-based centers.
Methods:
A cohort of 113 patients managed by a CVOB team at a non-university health system (2018-2019) were compared to 338 patients seen by cardiology prior to the program (2016-2017). CVOB patients were matched with comparison patients (controls) on modified World Health Organization (mWHO) category classification, yielding a cohort of 102 CVOB and 102 controls.
Results:
CVOB patients were more ethnically diverse and cardiovascular risk was higher compared to controls based on mWHO ≥ II-III (57% vs 17%) and. After matching, CVOB patients had more cardiology tests during pregnancy (median of 8 tests vs 5, p < .001) and were more likely to receive telemetry care (32% vs 19%, p = .025). The median number of perinatology visits was significantly higher in the CVOB group (8 vs 2, p < .001). Length of stay was a half day longer for vaginal delivery patients in the CVOB group (median 2.66 vs 2.13, p = .006).
Conclusion:
Implementation of a CVOB program resulted in a more diverse patient population than previously referred to cardiology. The CVOB program participants also experienced a higher level of care in terms of increased cardiovascular testing, monitoring, care from specialists, and appropriate use of medications during pregnancy.
More Related Videos
Related Concept Videos
01:14Fetal Circulation
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...
01:15Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.