Presented September 3, 2025 at the 2025 APSF Stoelting Conference on “Transforming Maternal Care: Innovations and Collaborations to Reduce Morbidity and Mortality”
SUMMARY
Jennifer Banayan, MD’s presentation on Cardio-Obstetrics highlights that cardiovascular disease (CVD) is the leading cause of pregnancy-related mortality in the U.S., a rate that tripled between 1999 and 2021. Pregnancy serves as a “nature’s stress test,” unmasking or worsening underlying cardiac pathology due to dramatic hemodynamic shifts. The talk emphasizes that over half of these preventable deaths occur in the postpartum period due to delayed diagnosis and fragmented care. The call to action is centered on implementing a multidisciplinary “Pregnancy Heart Team” involving OB, Cardiology, and Anesthesiology to standardize risk stratification, proactive planning, and dedicated postpartum monitoring, such as in an Intermediate Medical Unit, to close the crucial post-delivery gap.
Key Points:
- Leading Cause of Mortality
Cardiovascular disease is the most common cause of pregnancy-related death in the U.S., accounting for approximately one-third of all such deaths [03:02, 03:09]. Peripartum cardiomyopathy is the most frequent specific cause [03:31]. - Vulnerable Time Window
Over half of cardiovascular-related maternal deaths occur in the postpartum period after the patient has been discharged from the hospital, demonstrating a failure in the healthcare system’s transition of care [10:14]. - Diagnostic Challenge
Cardiac symptoms (e.g., shortness of breath, palpitations) are often dismissed as normal pregnancy physiology or anxiety, leading to a delay or misdiagnosis that contributes to up to three-quarters of these preventable deaths [07:13, 07:40]. - Impact of Demographics
The increasing age of childbearing women (50% of births are to women over 35) introduces a greater burden of comorbidities (e.g., hypertension, diabetes), which elevate cardiovascular risk and contribute to rising mortality rates [05:45, 06:05]. - Solution: Multidisciplinary Care
The implementation of a formal Pregnancy Heart Team (involving OB, Cardiology, Anesthesia, MFM, and Nursing) is the most effective way to improve outcomes by enabling standardized risk stratification, proactive planning, and better communication before and during delivery [12:05, 12:29].
ABOUT THE SPEAKER(S)
Jen Banayan, MD
Associate Professor,
Northwestern University, Feinberg School of Medicine
Editor of APSF Newsletter
Jennifer Banayan, MD, is an associate professor at Northwestern Feinberg School of Medicine where she practices obstetric anesthesia. She completed her anesthesia residency and cardiothoracic fellowship at University of Chicago. Her scholarly activity and educational contributions have been related to the intersection of her two clinical interests in cardiac and obstetric anesthesiology. Her academic career centers on maternal safety with a specific focus on maternal mortality, cardiac disease in the parturient, maternal resuscitation, and increasing provider utilization of focused cardiac ultrasound in the obstetric patient. She is editor of the APSF Newsletter.
