The Maternal Cardiac Care Team and the Maternal Cardiac Care Facility

Need for Maternal Cardiac Care Programs

A maternal cardiac care program requires the marshalling of significant resources, particularly in terms of personnel, space, and equipment. To justify these resources, we advise estimating the number of patients in need of such a program. An estimated 0.2% to 4.0% of pregnancies are complicated by cardiovascular disease. In our program, the prevalence of cardiac disease in pregnant women was 2.0%. In 0.7% of pregnancies, the cardiac disease was severe enough to require involvement of the cardiology service.

The expected event rate for fetal and maternal events in women with a spectrum of cardiac disease can be extrapolated from a 2001 Canadian study of 562 such women. The overall event rate was 13%. The fetal-neonatal death rate was 2%, and the rate of preterm labor was 10%. There were three cardiac deaths and two noncardiac deaths (suicide and amniotic fluid embolus).