Multidisciplinary Management of Pregnancy in Complex Congenital Heart Disease: A Model for Coordination of Care

Abstract

With advancements in medical care, many women with complex congenital heart disease (CHD) are now living into adulthood and childbearing years. The strains of pregnancy and parturition can be dangerous in such patients, and careful interdisciplinary plans must be made to optimize maternal and fetal health through this process. Several large studies have been published regarding risk prediction and medical management of pregnancy in complex CHD, though few case studies detailing clinical care plans have been published. The objective of this report is to describe the process of developing a detailed pregnancy and delivery care plan for three women with complex CHD, including perspectives from the multidisciplinary specialists involved in the process. This article demonstrates that collaboration between specialists in the fields of cardiology, anesthesiology, high-risk obstetrics, maternal fetal medicine, and neonatology results in clinically successful individualized treatment plans for the management of pregnancy in complex CHD. Multidisciplinary collaboration is a crucial element in the management of pregnancy in complex CHD. We provide a template used in three cases which can serve as a model for the design of future care plans.

Successful pregnancy and delivery in patients with uncorrected single ventricle: Three new cases and literature review

“…Interdisciplinary team management from the cardiologist, obstetrician, anesthetist, and neonatologist and detailed plan for delivery are critical for a good prognosis [30]. All patients in our reports received care from a multidisciplinary team.…”

A single-center experience with 12 consecutive cases of pregnancy among patients with membranous ventricular septal aneurysm

“…The relative good outcomes in our patients may be at least partially owing to the absence of severe hypertension, cardiac failure and cerebral and pulmonary embolism. In addition, comprehensive interdisciplinary management among the cardiologist, obstetrician, anesthetist, and neonatologist, and detailed plans for delivery may have improved the prognosis [ 23 ].…”

Managing the Adult Congenital Heart Disease Patient in the COVID-19 Pandemic—A New York Perspective

“…The use of patient-centered medical homes and care coordination, which have always been mainstays in care of the ACHD patient, is crucial during the COVID-19 pandemic in order to reduce risk of exposure [12,13]. For patients that require in person visits or testing, ACHD teams should coordinate care for visits with multiple providers or multiple testing modalities on the same day at the same location to minimize risk of exposure.…”