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Chronic Coronary Disease 2023

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53 Figure 10. Team-Based Cardio-Obstetrics Model of Care Cardio- Obstetrics Expert Cardiovascular Medicine Other Specialists Maternal Fetal Medicine Social Work Obstetrics Pharmacy Primary Care Nursing Anesthesiology Preconception • Contraception advice • Optimize medical status • Medication adjustment • Risk assessment: » mWHO » CARPREG II » ZAHARA Postpartum • Monitoring: minimum 48 hours • Assess and treat cardiovascular complications • Patient counseling on symptoms of complications Pregnancy • Team-based care with patient • Serial monitoring • Delivery planning balancing maternal/ fetal risks Fourth Trimester • 3–7 days follow-up post-discharged • Comprehensive evaluation within 6 weeks • Consider addition of telehealth visits • Contraception Labor/Delivery • Mode: Vaginal delivery usually preferred • Regional anesthesia • Monitoring: consider pulse oximetry, telemetry if indicated Long-Term • Identify women with APO (preeclampsia and hypertensive disorders, gestational diabetes, preterm delivery, small for gestational age) • CVD risk screening Cardio-Obstetrics Team and Patient e cardio-obstetrics model of care involves multiple specialists working together and with the patient to address issues from preconception, through pregnancy and delivery, and the postpartum period. Modified with permission from Davis MB, et al. J Am Coll Cardiol. 2021;77:1763-1777. Copyright 2021 American College of Cardiolog y Foundation.

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