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Bridging the Gap in Cardiovascular Disease During Pregnancy

In This Video

  • Cardiovascular disease is the leading cause of mortality in women, yet female patients remain significantly underrepresented in studies
  • The U.S. maternal mortality rate is one of the highest among developed nations and continues to rise
  • The HOPE registry is a national collaboration between cardiologists and obstetricians to address knowledge gaps in treating cardiovascular disease in pregnancy
  • Women are particularly vulnerable to cardiovascular complications during the postpartum period

In this video, Amy Sarma, MD, cardiologist in the Corrigan Women's Heart Health Program at Massachusetts General Hospital, discusses her research into the underrepresentation of women in cardiovascular disease studies and the importance of collaboration between cardiology and obstetrics in preventing maternal mortality. Dr. Sarma is involved in the HOPE registry, which aims to address knowledge gaps in the treatment of cardiovascular disease during pregnancy.


Dr. Sarma: I became really interested in cardiovascular disease in pregnancy actually when I first started my medical training. So, as I was going through and taking care of patients after a number of cardiovascular events and looking at the primary data that we use to take care of women, I was realizing that a lot of the big trial data have women significantly underrepresented. And so it became unclear whether or not for that individual patient that we were taking care of, whether they really fit into the data or the studies that were being conducted to treat women and men after acute coronary syndromes—and heart failure—and a myriad of other clinical conditions. It's currently the leading cause of mortality in women, and women still remain significantly underrepresented in studies. And, really a big knowledge gap that I was very interested in filling.

We're very fortunate to have such a robust cardiovascular disease in pregnancy program. And, it's a really remarkable collaboration between Cardiology and Obstetrics. And despite the fact that we have such a rich program at Massachusetts General Hospital and other sites around the world, we still don't have a lot of data to guide our practice. And a lot of it is sort of, even among the guidelines and consensus statements that are published, expert opinion. And we can really do better for women in this country, particularly as the United States has one of the highest mortality rates, particularly among developed nations. And in fact, the maternal mortality in the United States is actually rising. We are not actually doing anything in our current practice patterns to stem these high mortality rates.

So, one of the ways that we are working to address these gaps in knowledge is through the HOPE registry which is a collaboration between cardiologists and obstetrics across the nation. We have several sites. It's a multisite collaboration which we are going to prospectively look at how we treat cardiovascular disease in pregnancy so that we can further our knowledge in this space.

One of the exciting things that we are thinking about moving forward with our program in cardiovascular disease in pregnancy is to think about novel ways to deliver care to women. And particularly we are focusing on the postpartum period during which women are particularly vulnerable to cardiovascular complications, but also the period of time where they're really not monitored by medical professionals. And so we are now working on several projects both in terms of developing clinical platforms, but also research infrastructure to think about how to improve this particularly vulnerable period of time for women.

Learn more about the Corrigan Women's Heart Health Program

Refer a patient to the Corrigan Minehan Heart Center

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An increasing number of pregnant women have cardiovascular disease, a major contributor to maternal morbidity and mortality. In a recent review, Doreen DeFaria Yeh, MD, and Emily Lau, MD highlight management strategies and encourage general cardiologists and obstetricians to collaborate to care for these women with highly complex cardiac conditions.


Malissa Wood, MD, co-director of the Corrigan Women’s Heart Health Program, discusses her team’s comprehensive and multidisciplinary approach to the care of the women with cardiovascular disease risk factors.