Perspective:

This study describes a population of patients managed by a cardio-obstetrics team at a quaternary hospital in New York City. The need for specialized cardio-obstetrics programs has arisen from increasing awareness of rising maternal mortality in the United States. CVD is now the leading cause of pregnancy-related deaths. Additionally, maternal mortality review committees have determined that many CVD-related deaths are preventable. Cardio-obstetrics teams involve multidisciplinary collaboration among cardiologists, obstetricians, maternal fetal medicine doctors, anesthesiologists, pharmacists, social workers, nurses, and others. In this study, the most common underlying cardiac conditions among pregnant patients were arrhythmias, cardiomyopathies, congenital heart disease, and valve disorders. Although the overall cohort had favorable maternal outcomes and low rates of readmission, there may be vast differences in risk among individual patients depending on the severity of the underlying CVD. Whether some women were counseled to not become pregnant is unknown. More research is needed about the management and outcomes of specific cardiac conditions during pregnancy. Multicenter collaboration among several cardio-obstetrics programs would allow for larger sample sizes of specific types of CVD during pregnancy. The Registry of Pregnancy and Cardiac disease (ROPAC) from the European Society of Cardiology has been informative, and additional efforts are underway for a pregnancy and heart disease registry in the United States. With more collaboration and larger data sets, we will be able to determine variations in management and outcomes for different populations and disease types.