Creating a Multidisciplinary Pregnancy Heart Team

被引:24
作者
Easter, Sarah Rae [1 ]
Valente, Anne Marie [2 ,3 ]
Economy, Katherine E. [1 ]
机构
[1] Harvard Med Sch, Brigham & Womens Hosp, Div Maternal Fetal Med, 75 Francis St, Boston, MA 02215 USA
[2] Boston Childrens Hosp, Dept Cardiol, Boston, MA USA
[3] Harvard Med Sch, Brigham & Womens Hosp, Dept Internal Med, Dept Med,Div Cardiol, Boston, MA 02115 USA
关键词
Pregnancy; Pregnancy Heart Team; Congenital heart disease; Cardiovascular disease; Maternal mortality; SAFETY CONSENSUS-BUNDLE; NATIONAL-PARTNERSHIP; OBSTETRIC OUTCOMES; CESAREAN DELIVERY; UNITED-STATES; WOMEN; CARE; DISEASE; MANAGEMENT; MORTALITY;
D O I
10.1007/s11936-020-0800-x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. 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.
引用
收藏
页数:14
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