Using a cardiac registry to highlight multidisciplinary care in pregnancy

Cardiac disease in pregnancy is linked to significant maternal and fetal risks. A cardiac registry provides a way to systematically collect data on pregnant women with cardiac disease, enabling analysis of outcomes, care approaches, and the development of improved clinical protocols.

To assess the role of a Pregnancy Heart Team (PHT) in managing cardiac disease during pregnancy, using data from a newly established registry at the National Maternity Hospital (NMH).

This was a prospective study analysing registry data from women attending the joint obstetric-cardiology clinic at NMH between January 2021 and September 2024. The registry included pregnant and pre-pregnancy patients. Demographics, cardiac diagnoses, risk classification, and maternal and neonatal outcomes were collected.

A total of 111 women with cardiac disease were captured, encompassing 153 pregnancies. Most women (87.6%, n = 134) had pre-existing cardiac disease, while 12.4% (n = 19) were newly diagnosed during pregnancy. Rhythm disorders were the most common diagnosis (60.3%, n = 91). 12.4% (n = 19) of women received pre-conceptual counselling. Risk stratification using the modified World Health Organization (mWHO) classification showed that 33.3% (n = 44) were class I, 34.1% (n = 45) class II, 25% (n = 33) class II-III, and 7.6% (n = 10) class III; no women were classified as mWHO IV. Cardiac events occurred in 16.4% (n = 26), most frequently in the third trimester (42.3%, n = 11), highlighting this as a high-risk period.

Registry findings highlights the importance of early, structured PHT care, to ensure optimal maternal and fetal outcomes.