Guidance Issued for Managing Heart Disease in Pregnancy
MONDAY, May 6, 2019 -- Recommendations have been developed for managing heart disease during pregnancy; the "Pregnancy and Heart Disease" practice bulletin was published in the May issue of Obstetrics & Gynecology.
Lisa M. Hollier, M.D., president of the American College of Obstetricians and Gynecologists, and colleagues from the Presidential Task Force on Pregnancy and Heart Disease, developed recommendations for care for pregnant and postpartum women with preexisting or new-onset acquired heart disease.
The authors note that the rising trend in maternal deaths related to cardiovascular disease seems to be due to acquired heart disease. Diagnosis of heart disease can be challenging during pregnancy because of the overlap of cardiovascular symptoms with those of normal pregnancy. The four key risk factors linked to cardiovascular disease-related maternal mortality are race/ethnicity, with non-Hispanic black women having a 3.4-fold increased risk for dying from cardiovascular disease-related pregnancy complications; age; hypertension; and obesity. Physiologic changes in pregnancy impact cardiovascular stress. Whenever possible, maternal health status should be optimized before pregnancy. Women with known cardiovascular disease should be assessed by a cardiologist before pregnancy or as early as possible during pregnancy. Management of moderate-risk and high-risk cardiovascular disease should take place in medical centers with a multidisciplinary Pregnancy Heart Team.
"The new guidance clearly delineates between common signs and symptoms of normal pregnancy versus those that are abnormal and indicative of underlying cardiovascular disease," Hollier said in a statement. "As clinicians, we need to be adept at distinguishing between the two if we're going to improve maternal outcomes."
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Posted: May 2019