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Cardiovascular disease is the leading cause of death related to pregnancy, but a new national survey conducted by doctors at the Smith Heart Institute in Cedars-Sinai shows that several cardiologists, trainees or caregivers are trained in obstetrics. a specialty that brings together specialists in cardiology, obstetrics and primary care.

The survey resultswhich were recently published in Art Journal of the American Heart Association (JAHA), found that only 29% of practicing clinicians reported receiving training in cardio-obstetrics during their training, and only 12% of fellows who reported reported formal training in the subspecialty.

In addition, 76% of respondents said they did not have access to a special cardio-obstetric team similar to the one in Cedars-Sinai.

“These results provide a clear picture of the lack of resources, education and training received by cardiologists, researchers and their teams in the field of cardio obstetrics,” said Natalie Bella, MD, MPH, director of hypertension research in Smidt. Heart Institute and lead author JAHA study. “As the level of cardiovascular disease associated with pregnancy is rising, now is the time to accelerate better and broader training in this area.”

About two-thirds of all maternal deaths are from Cardiovascular diseaseand most of them, Bella notes, can be prevented.

“Pregnancy is a stress test for the body,” said Sarah Kilpatyk, MD, PhD, chair of obstetrics and gynecology at Cedars-Sinai and national specialist in maternal and fetal medicine. “For some women it is stress test leads to sudden cardiovascular complications such as preeclampsia or health problems arising over time – even decades after pregnancy and childbirth. ”

Two of the most common hypertensive disorders of pregnancy are preeclampsia, a serious condition of blood pressure that develops during pregnancy or immediately after childbirth, and gestational hypertension, which is a recent increase in blood pressure during pregnancy. Both conditions are known to increase a woman’s risk heart diseaseheart failure and stroke later in life.

That’s why Kilpatyk, Bella, and broader cardio-obstetric teams, including physicians such as Dr. S. Anant Karumanchi, have been at the forefront of interventions for expectant and postpartum mothers.

Karumanchi, director of nephrology at Cedars-Sinai and a renowned physician who studies preeclampsia, is working to develop a diagnostic test to help doctors understand which patients with preeclampsia are most at risk for severe symptoms that can quickly become life-threatening.

The Smith’s Heart Postpartum Heart Health Program, part of the Barbra Streisand Women’s Cardiac Center, in collaboration with maternal fetal physicians, specializes in heart the health of women who had an adverse pregnancy outcome, including gestational hypertension, preeclampsia, postpartum hypertension, gestational diabetes, or spontaneous delivery earlier than 36 weeks.

“As we encourage the rapid development of training and care in obstetrics, we must at the same time encourage a woman who is considering childbirth to be aware of any complications or risk factors and to communicate openly with her primary care a doctor, cardiologist or obstetrician, ”said Kilpatik, also chair of the Los Angeles Department of Obstetrics and Gynecology.

New data from the Centers for Disease Control and Prevention (CDC) have shown that hypertensive disorders during pregnancy are on the rise and now affect 1 in 7 births in hospital. And about a third of those who died during childbirth in the hospital had hypertension pregnancy documentary.

“With our survey, new CDC data and countless other studies published recently, we need to act to ensure optimal care for all pregnant people,” Bella said. “While there is still a lot of work to be done, the good news is that deaths from hypertension can be avoided with timely diagnosis and treatment under the guidance of cardio-obstetric groups.”

Hypertensive pregnancy disorders associated with future cardiac events

Additional information:
Natalie A. Bella et al., The need for better and more extensive training in cardio obstetrics: National Survey of Cardiologists, Cardiovascular Members and Cardiology Fellows in Teaching, Journal of the American Heart Association (2022). DOI: 10.1161 / JAHA.121.024229

Citation: The Obstetrics and Gynecology Survey shows new training needs (2022, May 18), received May 18, 2022 from

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