Easter Sarah Rae, Valente Anne Marie, Economy Katherine E
Division of Maternal-Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA.
Department of Cardiology, Boston Children's Hospital; Department of Medicine, Division of Cardiology, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Curr Treat Options Cardiovasc Med. 2020 Jan 27;22(1):3. doi: 10.1007/s11936-020-0800-x.
Cardiovascular disease (CVD) is the leading cause of maternal death and cases of cardiovascular death are often associated with failure to provide timely risk-appropriate care. This review outlines considerations for creation of a team focused on the care of women with CVD during pregnancy and beyond.
Improved outcomes for women with complex medical or obstetric conditions managed by a multidisciplinary care team inspired national guidelines advising the creation of a Pregnancy Heart Team for women with CVD in pregnancy. The recommendations from the European Society of Cardiology provide general guidance for risk-appropriate care without elaborating on the details of these specialized care teams. A Pregnancy Heart Team led by providers from cardiology, maternal-fetal medicine, obstetrics, obstetric anesthesia, pharmacy, and nursing support a holistic approach to patient care while facilitating opportunities for cross-disciplinary education. This team should focus on frequent antepartum risk stratification, multidisciplinary delivery planning, and comprehensive preconception and postpartum care. Available evidence suggests that a consistent and integrated approach to care for women with CVD in pregnancy has the potential to decrease severe maternal morbidity and mortality. The cost-effectiveness of this approach and the impact of this comprehensive care model on a woman's long-term cardiovascular health warrant future study.
心血管疾病（CVD）是孕产妇死亡的主要原因，心血管死亡病例往往与未能提供及时的风险适宜护理有关。本综述概述了组建一个专注于孕期及产后患有CVD女性护理的团队的相关考量因素。
由多学科护理团队管理患有复杂内科或产科疾病女性的治疗结局得到改善，这促使国家指南建议为孕期患有CVD的女性组建妊娠心脏团队。欧洲心脏病学会的建议为风险适宜护理提供了总体指导，但未详细阐述这些专业护理团队的具体细节。由心脏病学、母胎医学、产科、产科麻醉、药学和护理人员组成的妊娠心脏团队支持对患者护理采取整体方法，同时促进跨学科教育的机会。该团队应专注于频繁的产前风险分层、多学科分娩计划以及全面的孕前和产后护理。现有证据表明，对孕期患有CVD的女性采用一致且综合的护理方法有可能降低严重孕产妇发病率和死亡率。这种方法的成本效益以及这种综合护理模式对女性长期心血管健康的影响值得未来研究。
