Novel collaborative cardiology and maternal fetal medicine practice – experience at the heart and pregnancy program

Abstract

Purpose

The Heart and Pregnancy Program (HPP) was created to evaluate and manage pregnant women with cardiac conditions simultaneously by cardiology and maternal-fetal medicine (MFM). The objective of our study was to describe the experience at this multidisciplinary program.

Methods

This is a retrospective review of women managed at HPP for over 4.5 years. Subjects were compared based on indication for referral.

Results

One hundred and seventy-three women were seen during the time period. Referral indications included cardiac complaints without history of cardiac disease (n = 49, 28.3%), known cardiac disease (n = 96, 55.5%), and other high-risk conditions (n = 28, 16.2%). Those with a known history of cardiac disease were significantly more likely to be nulliparous, and those referred for other high-risk conditions were significantly more likely to be obese. Most women underwent echocardiography (n = 137, 79.2%). For the 140 women who delivered at our hospital, the average gestational age at delivery was 38.8 weeks and the Cesarean rate was 41.4% (n = 58). No significant adverse perinatal outcomes were noted.

Conclusions

In our collaborative cardiology/MFM practice, most pregnant women had known cardiac disease. No significant adverse outcomes were noted. Our experience provides support for creating a joint model of care for pregnant women with cardiac disease.

Keywords:

• Cardiovascular disease
• collaborative care
• congenital heart disease
• multidisciplinary
• pregnancy

Disclosure statement

No potential conflict of interest was reported by the authors.