Importance of the Cardio-Obstetrics Team

Grodzinsky, Anna; Florio, Karen; Spertus, John A.; Daming, Tara; Lee, John; Rader, Valerie; Nelson, Lynne; Gray, Rebecca A.; White, Darcy; Swearingen, Kate; Thomas, Merrill; Singh, Annapoorna; Magalski, Anthony; Schmidt, Laura

doi:10.1007/s11936-019-0789-1

Cited by 26 publications

(11 citation statements)

References 9 publications

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“…76,108 In addition, the cardio-obstetrics team can identify women at high risk of developing cardiac complications, provide direct antenatal surveillance, and coordinate plans for a safe labor and delivery by recorded into medical records with clear delineation as to the provider responsible for each action item. 10,73,109,110 AHA advocates a care delivery infrastructure that supports equitable access to services for maternal health and well-being consistent with published guidelines from nationally recognized medical organizations and societies. Multidisciplinary, team-based care with specialists, such as cardiologists, maternal fetal medicine practitioners, primary care physicians, and adult congenital heart disease specialists, among others, is the cornerstone of improving pregnancy outcomes and the timely identification and mitigation of cardiac risks or complications.…”

Section: Recommendation 5: Modernize Health Care Delivery Infrastruct...mentioning

confidence: 99%

Call to Action: Maternal Health and Saving Mothers: A Policy Statement From the American Heart Association

Mehta¹,

Sharma²,

Creanga

et al. 2021

Circulation

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The United States has the highest maternal mortality rates among developed countries, and cardiovascular disease is the leading cause. Therefore, the American Heart Association has a unique role in advocating for efforts to improve maternal health and to enhance access to and delivery of care before, during, and after pregnancy. Several initiatives have shaped the time course of major milestones in advancing maternal and reproductive health equity in the United States. There have been significant strides in improving the timeliness of data reporting in maternal mortality surveillance and epidemiological programs in maternal and child health, yet more policy reforms are necessary. To make a sustainable and systemic impact on maternal health, further efforts are necessary at the societal, institutional, stakeholder, and regulatory levels to address the racial and ethnic disparities in maternal health, to effectively reduce inequities in care, and to mitigate maternal morbidity and mortality. In alignment with American Heart Association’s mission “to be a relentless force for longer, healthier lives,” this policy statement outlines the inequities that influence disparities in maternal outcomes and current policy approaches to improving maternal health and suggests additional potentially impactful actions to improve maternal outcomes and ultimately save mothers’ lives.

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Section: Recommendation 5: Modernize Health Care Delivery Infrastruct...mentioning

confidence: 99%

Call to Action: Maternal Health and Saving Mothers: A Policy Statement From the American Heart Association

Mehta¹,

Sharma²,

Creanga

et al. 2021

Circulation

View full text Add to dashboard Cite

show abstract

“…58 Ideally, a combination of clinics, cardiologist and obstetrician/maternal fetal medicine integrated appointments, as well as periodic interdisciplinary case conferences would establish foundational elements in both patient care as well as research and education in the field. 69 This cardio‐obstetrics team should be used at multiple points, starting with prenatal counseling through labor and delivery planning as well as close postpartum follow‐up and long‐term longitudinal care. Key prenatal visit elements include assessment of symptoms, medication review, preconception health evaluation, maternal cardiovascular risk screening with the mWHO scoring system (Table 3 ), 70 and patient education that would include advising against pregnancy for those women falling under mWHO class IV.…”

Section: The Interdisciplinary Cardio‐obstetrics Team: Maternal Care Reimaginedmentioning

confidence: 99%

Maternal Heart Failure

Bright

Lima

Avila

et al. 2021

JAHA

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Heart failure (HF) remains the most common major cardiovascular complication arising in pregnancy and the postpartum period. Mothers who develop HF have been shown to experience an increased risk of death as well as a variety of adverse cardiac and obstetric outcomes. Recent studies have demonstrated that the risk to neonates is significant, with increased risks in perinatal morbidity and mortality, low Apgar scores, and prolonged neonatal intensive care unit stays. Information on the causal factors of HF can be used to predict risk and understand timing of onset, mortality, and morbidity. A variety of modifiable, nonmodifiable, and obstetric risk factors as well as comorbidities are known to increase a patient's likelihood of developing HF, and there are additional elements that are known to portend a poorer prognosis beyond the HF diagnosis. Multidisciplinary cardio‐obstetric teams are becoming more prominent, and their existence will both benefit patients through direct care and increased awareness and educate clinicians and trainees on this patient population. Detection, access to care, insurance barriers to extended postpartum follow‐up, and timely patient counseling are all areas where care for these women can be improved. Further data on maternal and fetal outcomes are necessary, with the formation of State Maternal Perinatal Quality Collaboratives paving the way for such advances.

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“…The nature of the multidisciplinary team can also provide an opportunity for clinicians in various subspecialties to provide comprehensive contraception counseling both antenatally and postpartum at their respective visits. 2 , 3 , 4 , 10 , 11 , 12 , 13 However, little is known about the Pregnancy Heart Team impact on contraception practices. Given this knowledge gap, we sought to understand contraceptive practices among people with CVD cared for by a multidisciplinary team by comparing their contraceptive plan and uptake with those of people with chronic comorbidities (high-risk cohort) and low-risk pregnancies (low-risk cohort) at a single institution.…”

Section: Introductionmentioning

confidence: 99%