TY - JOUR
T1 - How to set up a pregnancy heart team
AU - Rijs, K.
AU - van der Marel, C. D.
AU - van der Knijff-van Dortmont, A. L.M.J.
AU - Dons-Sinke, I. J.J.
AU - Adriaens, V. F.R.
AU - Cornette, J. M.J.
AU - Mulders, A. G.M.G.J.
AU - Duvekot, J. J.
AU - Driessen, M. M.P.
AU - van den Bosch, A. E.
AU - Cuypers, J. A.A.E.
AU - Kauling, R. M.
AU - Roos-Hesselink, J. W.
N1 - Publisher Copyright:
Copyright © 2025. Published by Elsevier B.V.
PY - 2025/12
Y1 - 2025/12
N2 - Cardiovascular disease (CVD) is the leading cause of maternal morbidity and mortality in developed countries, complicating 4–11 % of pregnancies. Women with CVD are at increased risk of maternal complications, including heart failure and arrhythmias, as well as adverse fetal outcomes such as preterm birth and perinatal mortality. Traditionally, care for pregnant women with CVD has been fragmented across specialties, leading to discontinuity and missed opportunities for optimization. To address this, recent European Society of Cardiology (ESC) guidelines strongly recommend the implementation of a pregnancy heart team: a dedicated multidisciplinary team providing integrated care for this high-risk population. We describe the implementation and organization of a pregnancy heart team in our academic tertiary hospital. The core team consists of a cardiologist specialized in cardio-obstetrics, a maternal-fetal medicine specialist, and an obstetric anesthesiologist, with additional experts consulted as required. Patients are discussed at predefined time points: preconception, during pregnancy, and postpartum. Standardized risk assessment using the modified World Health Organization (mWHO) classification guides counseling, management, and delivery planning. Shared decision-making is central, balancing maternal and fetal risks with patient preferences. The team establishes individualized peripartum care plans covering timing, mode, and location of delivery, anesthesia strategies, anticoagulation management, and postpartum monitoring. This structured, multidisciplinary model ensures continuity of care and offers a practical framework to improve outcomes in women with CVD during pregnancy.
AB - Cardiovascular disease (CVD) is the leading cause of maternal morbidity and mortality in developed countries, complicating 4–11 % of pregnancies. Women with CVD are at increased risk of maternal complications, including heart failure and arrhythmias, as well as adverse fetal outcomes such as preterm birth and perinatal mortality. Traditionally, care for pregnant women with CVD has been fragmented across specialties, leading to discontinuity and missed opportunities for optimization. To address this, recent European Society of Cardiology (ESC) guidelines strongly recommend the implementation of a pregnancy heart team: a dedicated multidisciplinary team providing integrated care for this high-risk population. We describe the implementation and organization of a pregnancy heart team in our academic tertiary hospital. The core team consists of a cardiologist specialized in cardio-obstetrics, a maternal-fetal medicine specialist, and an obstetric anesthesiologist, with additional experts consulted as required. Patients are discussed at predefined time points: preconception, during pregnancy, and postpartum. Standardized risk assessment using the modified World Health Organization (mWHO) classification guides counseling, management, and delivery planning. Shared decision-making is central, balancing maternal and fetal risks with patient preferences. The team establishes individualized peripartum care plans covering timing, mode, and location of delivery, anesthesia strategies, anticoagulation management, and postpartum monitoring. This structured, multidisciplinary model ensures continuity of care and offers a practical framework to improve outcomes in women with CVD during pregnancy.
UR - https://www.scopus.com/pages/publications/105021863095
U2 - 10.1016/j.ijcchd.2025.100635
DO - 10.1016/j.ijcchd.2025.100635
M3 - Article
AN - SCOPUS:105021863095
SN - 2666-6685
VL - 22
JO - International Journal of Cardiology Congenital Heart Disease
JF - International Journal of Cardiology Congenital Heart Disease
M1 - 100635
ER -
