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

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.