Key Takeaways

Cardiac disease is one of the leading causes of maternal mortality in the United States, making multidisciplinary cardio-obstetrics teams essential for improving outcomes.

Effective cardio-obstetrics teams should include maternal-fetal medicine specialists, experienced cardiologists, anesthesiologists, pharmacists, social workers, nurse navigators, and other specialists as needed, all centered around the patient.

Starting a cardio-obstetrics program doesn't require having everything in place at once - begin by identifying existing strengths and building from there with passionate team members.

Vaginal delivery is typically safer than cesarean section for women with cardiac conditions due to less blood loss and fewer rapid circulatory changes.

Standardized protocols should form the foundation of care, with individualization based on patient-specific factors like exercise tolerance, other medical conditions, and other health factors.

Communication style matters significantly in multidisciplinary teams - asking "can you tell me why" instead of "I'm not sure why" fosters collaboration rather than defensiveness.

Telemedicine and technology can help overcome major barriers to care, particularly transportation challenges in rural areas where hospitals are closing.

The biggest challenge in building cardio-obstetrics programs is often changing mindsets from competition to collaboration, with all team members understanding that the patient should be at the center.

Quotable Moments

"Cardiac disease is one of the leading killers of pregnant women in the United States in particular, not just during pregnancy, but in the postpartum period where women are left are often vulnerable."

"The cardiologist is not the obstetrician. So what cardiologists should not do or there should not be an overlap between delivery planning."

"Labor is like running a marathon and so therefore when one is in labor, there are a lot of shifts that go on that affect the heart."

"Vaginal delivery is, is much easier. You're much less likely to lose blood. It is much better for the baby."

"It is quite difficult to navigate pregnancy even when it's normal. But now when you're asking a patient to come in, take medications, see the cardiologist, see the maternal fetal medicine specialist, sometimes they already have an obstetrician, they need to have a scheduled appointment with the anesthesiologist, it can be overwhelming."

"I believe in starting small is important, find what you need to do and, and we talk about this in the CCOC bundle. Find what your team is already doing."

"The hallmark of care should be your standardized protocols. You should start there."

"I think you have to balance moving toward programming. Say okay, if you want me to build a cardio obstetrics program because we are the level four regional perinatal center in my area, these are the resources I'm going to need."

"I always talk about this a lot as how you ask questions and how you present yourself really helps team dynamics."

"If I've conveyed to the patient as somehow one of the team members doesn't, is not trustworthy or really doesn't know what they're doing, then the patient loses trust in the whole team."

"We should be talking about equity, but we should be talking about health justice. because there's so many barriers in the American medical system to getting care."

"If the patient is at the center, then we all join hands around the patient to make sure that there are just no gaps in the care that the, that patient receives."

Show Notes by Barevalue

No content or comments made in any TIPQC Healthy Mom Healthy Baby Podcast is intended to be comprehensive or medical advice. Neither healthcare providers nor patients should rely on TIPQC’s Podcasts in determining the best practices for any particular patient. Additionally, standards and practices in medicine change as new information and data become available and the individual medical professional should consult a variety of sources in making clinical decisions for individual patients. TIPQC undertakes no duty to update or revise any particular Podcast. It is the responsibility of the treating physician or health care professional, relying on independent experience and knowledge of the patient, to determine appropriate treatment.