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Creating a Multidisciplinary Pregnancy Heart Team

  • Pregnancy and Cardiovascular Disease (N Scott, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Cardiovascular disease (CVD) is the leading cause of maternal death and cases of cardiovascular death are often associated with failure to provide timely risk-appropriate care. This review outlines considerations for creation of a team focused on the care of women with CVD during pregnancy and beyond.

Recent findings

Improved outcomes for women with complex medical or obstetric conditions managed by a multidisciplinary care team inspired national guidelines advising the creation of a Pregnancy Heart Team for women with CVD in pregnancy. The recommendations from the European Society of Cardiology provide general guidance for risk-appropriate care without elaborating on the details of these specialized care teams.

Summary

A Pregnancy Heart Team led by providers from cardiology, maternal-fetal medicine, obstetrics, obstetric anesthesia, pharmacy, and nursing support a holistic approach to patient care while facilitating opportunities for cross-disciplinary education. This team should focus on frequent antepartum risk stratification, multidisciplinary delivery planning, and comprehensive preconception and postpartum care. Available evidence suggests that a consistent and integrated approach to care for women with CVD in pregnancy has the potential to decrease severe maternal morbidity and mortality. The cost-effectiveness of this approach and the impact of this comprehensive care model on a woman’s long-term cardiovascular health warrant future study.

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Summary

The complexities of parturition for women with CVD demand the involvement of a multidisciplinary Pregnancy Heart Team with a standard approach to antenatal, intrapartum, and interconception care. Involving specialists from cardiology, maternal-fetal medicine, obstetric anesthesia, and nursing supports a holistic approach to patient care while facilitating opportunities for cross-disciplinary education. Available evidence suggests that a stable team of providers with frequent multidisciplinary care planning meetings may optimize outcomes for women with CVD in pregnancy.

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Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA

    Sarah Rae Easter MD & Katherine E. Economy MD, MPH

  2. Department of Cardiology, Boston Children’s Hospital; Department of Medicine, Division of Cardiology, Department of Internal Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Anne Marie Valente MD

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  1. Sarah Rae Easter MD
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  2. Anne Marie Valente MD
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Correspondence to Sarah Rae Easter MD.

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Sarah Rae Easter, Anne Marie Valente, and Katherine Economy declare that they have no conflict of interest.

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Easter, S.R., Valente, A.M. & Economy, K.E. Creating a Multidisciplinary Pregnancy Heart Team. Curr Treat Options Cardio Med 22, 3 (2020). https://doi.org/10.1007/s11936-020-0800-x

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