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Obstetric Quality and Safety

Poster Session 3

(703) UCSD Health CardioObstetrics Initiative: A Multidisciplinary Team to Improve Outcomes in the Pregnant Cardiac Patient

Wednesday, February 14, 2024
8:30 AM – 10:00 AM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Cardiovascular disease is the leading cause of maternal death in the United States. Despite professional obstetric and cardiology societies advocating for multidisciplinary care of cardiac patients in pregnancy, this care is not often standardized even at large academic centers. In 2020, we established a monthly conference to review prenatal course and develop safe delivery plans for pregnant patients with cardiac disorders.

Study Design: This is a description of our multidisciplinary program and summary of patients who have been enrolled in our CardioObstetrics Care Conference since 2020. Every patient discussed in our conference is assigned a class corresponding to the Modified World Health Organization (WHO) Classification of Maternal Cardiovascular Risk. These scores range from 1 to 5 with 1 denoting a low-risk lesion unlikely to cause problems in pregnancy (eg successfully repaired simple defect) and 5 corresponding to a high risk of mortality with termination recommended (eg pulmonary arterial hypertension). The data presented summarizes the demographics and birth outcomes of our cohort stratified by WHO Risk Class.

Results: Since starting our program, we have enrolled 121 patients with the majority falling into WHO Risk Classes 1 to 3. Most of our patient cohort self-identified as White, around half as Hispanic, and roughly even numbers were covered by private and public insurance. While increasing BMI was statistically related with worsening pathology, other demographic characteristics and mode of delivery did not vary significantly by WHO Risk Class (Table 1).

Conclusion: In the 3 years since its inception, our CardioObstetrics Care Conference has facilitated care for a diverse group of 121 patients with cardiac disease in pregnancy. In our cohort, increasing BMI is statistically related to higher WHO Risk Class while mode of delivery appears unrelated.