Cardiac Conditions in Pregnancy
Cardiovascular disease is a leading cause of pregnancy complications and leading cause of death among women in the U.S. accounting for about 1 in every 3 female deaths. Congenital heart disease is the most common heart disease affecting pregnancies in the U.S., but cardiomyopathy causes the most serious complications. Some of these diseases may be exacerbations of pre-existing conditions that the pregnant woman may already have, or they may develop a new disease process that presents because of the complex hormonal changes and physiology of pregnancy.
In Georgia the leading causes of pregnancy-related death were hemorrhage (16; 14%), mental health conditions (15; 13%), cardiomyopathy (13; 12%), cardiovascular and coronary conditions (12; 11%), embolism (12; 11%), and eclampsia and preeclampsia (10; 9%)
- The combination of cardiomyopathy and cardiovascular/coronary conditions accounted for 25 (23%) of maternal deaths
The American College of Obstetricians and Gynecologists (ACOG) recommends the CVD Risk Assessment be used to universally screen all mothers who are pregnant and up to 365 days postpartum. Using a validated CVD Risk Assessment screening tool can help identify pregnant and postpartum persons who may be at increased risk of Cardiovascular complications.
To combat the steadily increasing maternal mortality rate, the Georgia Perinatal Quality Collaborative (GaPQC) leads statewide implementation of quality improvement initiatives through technical assistance, quality improvement training, education, and data support to hospitals
Recognizing the large impact of Cardiac Conditions on Maternal Mortality, the GaPQC is focused on the implementation of the Alliance for Innovation on Maternal Health (AIM), Cardiac Conditions in Obstetrical Care (CCOC) patient safety bundle starting in summer 2022.
The goal of the GaPQC’s implementation of the CCOC initiative is to reduce severe morbidity and mortality related to maternal cardiac conditions in Georgia. GaPQC’s AIM will reduce harm related to existing and pregnancy related cardiac conditions through the 4th trimester by 20%. About GaPQC (georgiapqc.org)
Pre-existing cardiovascular and related conditions may include:
- Congenital heart disease and defects
- Arrythmias
- Hypertensive disorders
- Valvular Stenosis and Insufficiency in pregnancy
- Coronary artery disease
- Peripheral artery disease (PAD)
- Diabetes Mellites
Cardiovascular Conditions Arising During and After Pregnancy may include:
- Arrhythmias
- Hypertension
- Pregnancy- associated myocardial infarction (MI)
- Peripheral Artery Disease (PAD)
As a health care provider, it is critical to
- Identify cardiovascular disease risk factors through accurate history taking.
- Evaluate heart disease in pregnant females will require advanced workup. High-risk patients should be managed at expert centers with a multidisciplinary pregnancy heart team.
- Follow guidelines for the management of cardiovascular diseases during pregnancy
Please take a few minutes to review Alliance for Innovations on Maternal Health (AIM) safety bundle on cardiac conditions in obstetric care by the American College of Obstetricians and Gynecologists (ACOG).
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