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During Pregnancy Postpartum
Close maternal monitoring for HF signs
or symptoms or other cardiovascular
instability by cardiolog y and obstetric and
maternal-fetal medicine teams; close fetal
monitoring by the obstetric and maternal-
fetal medicine teams.
Consideration of routine
echocardiographic screening in the third
trimester for reassessment of myocardial
structure and function before labor;
echocardiography for any significant
changes in HF symptoms or signs during
pregnancy, or if HF medications are
reduced or discontinued.
BNP or NT-proBNP monitoring during
pregnancy may have some value for
prediction of cardiovascular events.
Close maternal monitoring by obstetrics
and maternal-fetal medicine teams for
preeclampsia, which has shared risk factors
and pathogenesis with PPCM.
For women presenting with
decompensated HF or cardiogenic shock,
hemodynamic monitoring and MCS, as
appropriate, within a multidisciplinary
collaborative approach that supports
prompt decision-making about the timing
and mechanism of delivery.
Multidisciplinary recommendations from
obstetrics and neonatolog y and pediatrics
teams and shared decision-making
regarding the maternal and neonatal risks
and benefits of breastfeeding.
For women presenting with
decompensated HF or cardiogenic
shock, HF management should include
hemodynamic monitoring and mechanical
circulatory support as appropriate
