The role of the pregnancy heart team in clinical practice

Lucà, Fabiana; Colivicchi, Furio; Parrini, Iris; Russo, Maria Giovanna; Fusco, Stefania Angela Di; Ceravolo, Roberto; Riccio, Carmine; Favilli, Silvia; Rossini, Roberta; Gelsomino, Sandro; Oliva, Fabrizio; Gulizia, Michele Massimo

doi:10.3389/fcvm.2023.1135294

Cited by 6 publications

(3 citation statements)

References 110 publications

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“…The assigned risk colour code was strongly correlated with maternal outcomes. Since then, a few studies have provided insights into the logistic considerations and required building blocks to create a strong pregnancy heart team, 122 , 123 and we can expect further publications on the implementation and evaluation of such teams in the years to come.…”

Section: Special Considerations In Pregnant Women With Aortopathymentioning

confidence: 99%

Female-Specific Considerations in Aortic Health and Disease

Crosier,

Lopez Laporte,

Unni

et al. 2024

CJC Open

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Section: Special Considerations In Pregnant Women With Aortopathymentioning

confidence: 99%

Female-Specific Considerations in Aortic Health and Disease

Crosier,

Lopez Laporte,

Unni

et al. 2024

CJC Open

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“…Regular follow-up appointments with a multidisciplinary healthcare team, including obstetricians and cardiologists, are crucial for assessing maternal well-being and fetal development. Diagnostic tools such as echocardiography, ECG, and ambulatory monitoring remain instrumental in tracking cardiac function changes and identifying emerging issues [ 13 ]. Particular attention should be given to monitoring heart rate, rhythm, and signs of heart failure.…”

Section: Reviewmentioning

confidence: 99%

Navigating the Complexity: A Comprehensive Review of Managing Pregnancy in Complete Heart Block Cases

Agarwal,

Murkey,

Pandit

et al. 2023

Cureus

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This review explores the comprehensive management of pregnancy in cases of complete heart block, a cardiac condition characterized by the dissociation between atrial and ventricular conduction. The review begins with a thorough examination of preconception counseling, emphasizing the assessment of maternal health, the evaluation of cardiac function, and the identification of potential risks. Subsequently, the medical management section delves into using beta-blockers, pacemakers, and antiarrhythmic drugs to monitor cardiac function during pregnancy and adjust medication regimens. Obstetric considerations highlight the importance of antenatal care, fetal monitoring, and thoughtful delivery planning, including the choice between vaginal delivery and cesarean section. The section on complications underscores the risks of arrhythmias, heart failure, premature birth, and neonatal cardiac issues. Looking ahead, the future directions and research section explores ongoing studies in genetics, pharmacology, and technological innovations, envisioning potential advancements in pacing technology and personalized medicine approaches. The conclusion synthesizes key findings, offering recommendations for clinical practice and reflecting on the challenges and opportunities inherent in managing pregnancy in complete heart block cases. The multidisciplinary approach emerges as paramount, with collaborative efforts paving the way for improved patient outcomes and advancements in the field.

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“…Moreover, anti-arrhythmic and anti-coagulation therapies should be used cautiously. Follow-up during pregnancy should be performed by a Pregnancy Heart Team (PHT), or Cardio-Obstetric Team, composed of experienced cardiologists, gynecologists, anesthesiologists, obstetricians and nurses, with at least one visit per trimester [ 127 , 128 , 129 ]. The main aim is to achieve both maternal and fetal safety.…”

Section: Clinical Perspectives and Challenges Regarding Af During Pre...mentioning

confidence: 99%

The Challenge of Managing Atrial Fibrillation during Pregnancy

Lucà,

Oliva,

Abrignani

et al. 2023

Rev. Cardiovasc. Med.

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The incidence of atrial fibrillation (AF) during pregnancy increases with maternal age and with the presence of structural heart disorders. Early diagnosis and prompt therapy can considerably reduce the risk of thromboembolism. The therapeutic approach to AF during pregnancy is particularly challenging, and the maternal and fetal risks associated with the use of antiarrhythmic and anticoagulant drugs must be carefully evaluated. Moreover, the currently used thromboembolic risk scores have yet to be validated for the prediction of stroke during pregnancy. At present, electrical cardioversion is considered to be the safest and most effective strategy in women with hemodynamic instability. Beta-selective blockers are also recommended as the first choice for rate control. Antiarrhythmic drugs such as flecainide, propafenone and sotalol should be considered for rhythm control if atrioventricular nodal-blocking drugs fail. AF catheter ablation is currently not recommended during pregnancy. Overall, the therapeutic strategy for AF in pregnancy must be carefully assessed and should take into consideration the advantages and drawbacks of each aspect. A multidisciplinary approach with a “Pregnancy-Heart Team” appears to improve the management and outcome of these patients. However, further studies are needed to identify the most appropriate therapeutic strategies for AF in pregnancy.

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The role of the pregnancy heart team in clinical practice

Cited by 6 publications

References 110 publications

Female-Specific Considerations in Aortic Health and Disease

Female-Specific Considerations in Aortic Health and Disease

Navigating the Complexity: A Comprehensive Review of Managing Pregnancy in Complete Heart Block Cases

The Challenge of Managing Atrial Fibrillation during Pregnancy

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