Abstract 11239: Changes in Clinical Outcomes for Patients Enrolled in a Non-Academic Multidisciplinary Cardio-Obstetrics Program

Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of maternal death. Maternal mortality has steadily increased in the US. More than 60% of deaths due to CVD are preventable. In 2018, a non-academic multidisciplinary cardio-obstetrics (CVOB) program was formed at a Midwest hospital system. Cardiologists and Maternal Fetal Medicine specialists work together to provide evidence-based care to pregnant women with cardiac risk. To assess program effectiveness, we compared women seen by the CVOB program in 2018/2019 with a sample of pregnant women seen by cardiology in 2016/2017 prior to the program’s inception. Hypothesis: Women seen by the CVOB program will have improved outcomes - measured by gestation at delivery, length of stay (LOS) and readmission rates - over pre-program controls. Methods: A retrospective chart review was conducted of 102 patients who received care from the CVOB program in 2018/2019. These women were matched 1:1 based on mWHO categories with women who were seen by cardiology in 2016/2017. Results: Women who received care in the CVOB program had more cardiology tests during pregnancy relative to pre-program controls (median of 8 tests vs 5; p <0.001). Women in the CVOB program had a longer LOS (median of 3.08 vs 2.55 days; p=0.02). Women in the CVOB program were less likely to have inpatient or ED visits in the 6 months postpartum (24% vs 72%; p <0.001). Gestational age was similar at time of delivery. Conclusions: In a multidisciplinary, non-academic CVOB program; there was a trend towards an increase in LOS after delivery, as well as in increase in ICU utilization. However, there were fewer readmissions or emergency visits in the post-partum period. A multidisciplinary CVOB program is feasible in a non-academic setting. The development of the program led to a decrease in the rates of readmission and ED visits in the postpartum period.