The changes to the heart and vascular system during pregnancy can be especially challenging for women with cardiovascular disease (CVD) or preexisting heart conditions. In fact, CVD is a leading cause of maternal mortality, accounting for 33% of maternal deaths in the United States.
Women with cardiac disease who are pregnant have special needs and considerations. To support this growing population, the Cardiovascular Obstetrics Clinic at Mayo Clinic offers a multidisciplinary approach that ensures both mothers and unborn children receive the best specialized care during the entire pregnancy journey.
“To meet the needs of this unique patient population, we offer services in a coordinated fashion between cardiology and maternal fetal medicine,” says Katie A. Young, M.D., a cardiologist and co-director of the Cardiovascular Obstetrics Clinic at Mayo Clinic in Rochester, Minnesota.
Watching for cardiovascular changes in pregnancy
During pregnancy, physical changes occur to support the growing fetus. Blood volume expands by nearly 50% of the baseline volume, and the heart’s output per minute increases drastically. These physiological adjustments help manage the increased demands on the cardiovascular system — a safeguard that ensures the mother and developing fetus receive sufficient blood supply while simultaneously reducing the strain on the heart. However, for women with acquired or congenital heart disease whose bodies may struggle to adapt to the additional stress, pregnancy becomes a particularly critical and high-risk time.
Caring for women throughout pregnancy
Mayo Clinic’s Cardiovascular Obstetrics Clinic offers specialized care for pregnant women with cardiovascular conditions. “Women seen by our practice may have a variety of cardiac conditions, such as congenital heart disease, arrhythmias, cardiomyopathies or valve disease, that require closer monitoring,” says Dr. Young. They also may be more susceptible to preeclampsia, gestational hypertension and gestational diabetes. These health concerns have long-term implications, including a higher risk of cardiovascular death as well as heart failure, heart attack and hypertension.
For patients with known cardiac disease, preconception counseling services are offered to help educate them on individualized risks through pregnancy, manage medications and provide support particularly if they are advised against pregnancy due to their heart condition. “I think patients take comfort in knowing they have access to a team who can offer counseling and development of a comprehensive care plan for a future pregnancy,” says Dr. Young.
Other services at the clinic include:
• Monitoring during pregnancy: Periodic clinical monitoring helps manage maternal cardiovascular health.
• Delivery planning: Coordinated care during delivery ensures the safety of both mothers and babies.
• Postpartum follow-up: Ongoing care after delivery manages and mitigates any cardiovascular risks.
“At Mayo Clinic, we wanted to formalize a cardio-obstetric program to help ensure women feel confident in their cardiovascular care through pregnancy.”
— Katie A. Young, M.D.
Making pregnancy safer for all women
Although historically women are not as well studied as men, there has been a push in women’s heart health equality through research and clinical trials. Recent studies from Mayo Clinic indicate that artificial intelligence (AI) could enhance the diagnosis of peripartum cardiomyopathy, a serious yet treatable condition that weakens the heart muscle during or after pregnancy. By using an AI-enabled digital stethoscope that records electrocardiogram (ECG) data and heart sounds, researchers were able to detect twice as many cases of peripartum cardiomyopathy compared with standard care.
Although the AI digital stethoscope is not yet widely available, technology plays a key role in prenatal and maternal care. This is particularly important when underlying heart issues mimic typical pregnancy experiences. For instance, a weakened heart pump can cause shortness of breath when lying down, swelling of the hands and feet, weight gain, and a rapid heartbeat — all of which are often mistaken for normal pregnancy changes. Innovative tools like the AI digital stethoscope can help physicians accurately distinguish between what is a normal part of pregnancy and what may indicate a more serious health concern.
mayoclinic.org/visitorguide | 507-923-2566
