Table 2.
Suggested Timetable for Involvement of the Pregnancy Heart Team During Prepregnancy, Antenatal, Labor and Delivery, and Postnatal Time Periods for Patients With Cardio‐Obstetric Conditions
| Variable | HDP | GDM | CAD | Cardiomyopathy | ACHD‐Modified WHO Category | ||
|---|---|---|---|---|---|---|---|
| Ia | IIb | IIIc | |||||
| Prepregnancy consultation | +/− | +/− | + | + | + | + | + |
| Pregnancy heart team consultation/counseling during antenatal care | + | + | + | + | + | + | |
| Delivery at tertiary care center (level III maternal care capability facilityd) | +/− | + | + | +/− | +/− | + | |
| Long‐term follow‐up by cardiovascular specialist | +/− | +/− | + | + | + | + | + |
ACHD indicates adult congenital heart disease; CAD, coronary artery disease; GDM, gestational diabetes mellitus; HDP, hypertensive disorders of pregnancy; and WHO, World Health Organization; +, needed; ‐, not needed.
ACHD‐modified WHO category I: Simple disease, such as small atrial septal defects or repaired ductus arteriosus.
ACHD‐modified WHO category II: Moderate complexity disease, such as ostium primum atrial septal defects or repaired tetralogy of Fallot.
ACHD‐modified WHO category III: Great complexity disease, including transposition of the great arteries, mitral atresia, or single‐ventricle physiological features.
Level III maternal care capability facilities are able to provide care for complex medical conditions, obstetrical complications, and fetal conditions.