In this presentation,
Dr. Jason Vaught, maternal fetal medicine specialist and surgical critical care physician, provides an overview of our Cardio-Obstetric Program that offers heart disease treatment and prevention in women that are pregnant or are thinking about becoming pregnant who are at increased cardiovascular risk. For details on how to refer a patient, please call 410-502-3200.
Hello. My name is DR Jason, vote and I'm the director of labor and delivery at the johNS Hopkins Hospital and I'm also an assistant professor of gynecology and obstetrics and surgery here as well. And I'm here to talk about an innovative and consolidated program for Women with maternal cardiac disease through our cardio obstetrics program. So first, what is maternal cardiac disease? Well, initially the phrase was coined to really encompass women that had chronic hypertension and hypertensive disorders of pregnancy like pre eclampsia. However, recently maternal Kartik diseases referring to women that has central Kartik disease to their heart. So this includes room with the order to these like Marfan syndrome, cardiomyopathy, heart failure, valvular disease or dysfunction. Arrhythmias and congenital heart disease. Both prepared and unprepared. So why is this important? As we know? The cardiac output increases by approximately 50 to 60% by the mid second trimester and it peaks during labor after labor. There is volume fluid shifts and the cardiac output does decrease. However, during this time women with women with maternal cardiac disease can have adverse cardiac events. In fact, approximately 15-16% of women that have maternal Kartik disease will have some form of adverse cardiac event. But the most common are arrhythmias and fluid overload requiring diaries. Is this is why the johNS Hopkins Hospital was charged with putting together the cardio obstetrics program. The program is both like I said, innovative and consolidated. So we see the patients with the cardiologist. Our team includes two maternal fetal medicine specialists with dual certification and critical care medicine including myself, two adult cardiologist and one adult cardiologist with specialization and adult congenital heart disease. Our team also includes our wonderful cardiology and maternal fetal medicine fellows. And we're able to do services on both the outpatient and inpatient basis. But we're more than just the team. We're in infrastructure at johNS Hopkins. We have both maternal infrastructure which includes obstetrical anesthesiologist, cardiac anesthesiologists, cardiac surgeons, vascular surgeons and our subspecialty clinics like the connective tissue disorder clinic for our fetal infrastructure. We have a fetal center that is innovative in fetal echocardiogram, thick and synagogue in Sana graphic techniques. We provide first trimester preeclampsia screening and we have A level for nick. You if the neonatal should need it the levels of maternal period that we provide our vast we can provide outpatient consultation services but we also can provide in patient care that delivery planning and even be at the delivery for some of our moms. Most importantly, our labor and delivery is equipped to take care of women with maternal cardiac disease. As you can see here, we have cardiac monitoring capabilities as well as arterial monitoring capabilities with our telemetry monitoring but also importantly we have our neonatal bed so after the delivery, the mother can continue to bond with her baby on LSD and not have to be moved to a CCU for continue cardiac monitoring. It's also really important is that just because someone has maternal cardiac disease does not mean that they get a C. Section at johns Hopkins Hospital for that reason alone. When we looked at more than 14,000 deliveries and 200 women that had maternal cardiac disease between 2016 and 2020, we actually found that having maternal cardiac disease did not increase the risk of having Cesarean section at our hospital. We see many other types of women in our cardio obstetrics program as well. We can see women with intractable hypertension which redefined as being on more than two anti hypertensive medications. Women with chronic kidney disease, women with confident disorders and autoimmune diseases, human logic disorders including Manuela brands disease And women with a history of early preterm preeclampsia or gestation of less than 34 weeks. We also see women with lipid disorders and women that have had a history of myocardial infarction. So what's the referral process? Well, it's easy call 410502 32 100. And it has to be referred in our cardio obstetrics program and hopefully will correspond with you shortly