bySociety for Maternal-Fetal Medicine

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Prepregnancy counseling, assembling multidisciplinary care teams, and referring to centers with expertise are critical in managing pregnant patients with heart failure to optimize maternal and newborn health outcomes, according to new guidance issued by the Society for Maternal-Fetal Medicine (SMFM). Consult Series #73,"Diagnosis and management of right and left heart failure during pregnancy and postpartum," outlines recommendations for physicians on counseling and managing patients with heart failure. It is published in the journalPregnancy.

Heart disease is a leading cause of pregnancy-related deaths in the U.S., a disproportionate percentage occurring among non-Hispanic Black individuals. Heart failure, a syndrome in which the heart is unable to pump blood effectively, is a major contributor tomaternal morbidityand mortality. Heart disease in pregnancy, includingheart failure, increases the risk of low birthweight, lower Apgar scores, premature birth, and death.

"Heart disease is a leading cause of maternal deaths, and it's a growing problem," said Arthur Jason Vaught, MD, a maternal-fetal medicine subspecialist and critical care physician at Johns Hopkins Medicine, and a member of the SMFM Publications Committee.

"This new guidance focuses attention on heart failure in pregnancy so that we can improve both short- and long-term quality of life for our patients. Getting accurately diagnosed and treated for heart disease, either before pregnancy or early in pregnancy, is both life-prolonging and life-changing if caught early."

The new SMFM recommendations focus on treating pregnant patients with reducedejection fraction(HFrEF) heart failure. Symptoms of heart failure include shortness of breath and fatigue, which can be normal symptoms of pregnancy. Heart failure can affect the heart's left ventricle,right ventricle, or both. The treatment for heart failure in pregnancy depends on which ventricle is impacted, whether it is acute or chronic, and other individual health factors.

More information: et al, Society for Maternal‐Fetal Medicine Consult Series #73: Diagnosis and management of right and left heart failure during pregnancy and postpartum, Pregnancy (2025). DOI: 10.1002/pmf2.70059

Provided by Society for Maternal-Fetal Medicine