Heart issues during pregnancy are often overlooked. We’re changing that—because every mother’s heart deserves to be heard, protected, and healed.
about us
What we do as the Cardiac Conditions in Obstetrical Care Committee
Heart health plays a crucial role in safe pregnancies—and when cardiac conditions go unrecognized, the risks can be life-threatening. The Cardiac Conditions in Obstetrical Care Committee works to raise awareness, improve clinical response, and support early identification of cardiovascular risks before, during, and after pregnancy. We collaborate with healthcare teams and community advocates to build knowledge, share best practices, and promote care that centers the needs and safety of women across Kentucky.
Cardiac Conditions within Obstetrical Care
Cardiovascular disease (CVD) is one of the leading causes of maternal mortality in Kentucky, contributing significantly to the state’s persistently high maternal death rate. Between 2018 and 2022, Kentucky’s maternal mortality rate was 34.6 deaths per 100,000 live births, much higher than the national average of 23.2 1
Cardiovascular conditions—including cardiomyopathy, hypertensive disorders, and other heart-related complications—are among the most common causes of maternal death, particularly among Black women 2
We overall look to decrease the number of emergency department and inpatient visits due to cardiac conditions in the maternal population by 10% by 2028.
Key to Prevention
Reducing maternal deaths starts with early detection and coordinated care. Through targeted training, standardized screening, and cross-disciplinary collaboration, we’re building a system that catches warning signs before they become emergencies.
Training
Train all obstetrical providers to perform a basic cardiac conditions screen. This includes Conducting cross-training among providers in OB-GYN, cardiology, emergency medicine, and maternal-fetal medicine and Integrating CREOG educational objectives on cardiac conditions into OB-GYN residency curricula.
Tool Development
Implement a standardized screening tool that includes:
- Patient history of cardiac conditions
- Patient-reported symptoms
- Vital signs
- Physical examination
Simulations/Drills
Interdisciplinary simulation drills will prepare providers to quickly recognize and respond to cardiac emergencies in pregnant and postpartum patients. These hands-on scenarios improve teamwork, clinical decision-making, and emergency readiness.
Standardization
A unified cardiac screening tool will be implemented across OB care settings. Standardized triage questions in EDs and EMS will help ensure early identification of cardiac risks during and after pregnancy.
More Info on Cardiac Conditions
Heart Disease in Pregnancy
Heart disease is the leading cause of death during pregnancy. This clinical guidance outlines how to recognize risks early, manage heart conditions safely, and support healthy outcomes.
Hypertension in Pregnancy
This expert guidance outlines how to safely diagnose and treat high blood pressure during pregnancy, with clear goals and medication recommendations.
ESC Guidelines
Explore the ESC’s expert guidelines on managing cardiovascular diseases during pregnancy. This resource offers evidence-based strategies to support safe, effective care for both mother and baby.
Available Tools
CARPREG II Risk Calculator
NYHA Functional Classification
The NYHA Functional Classification System is used by providers to communicate the patient’s current status and change in status across time.
| Class | Description | Limitation | Example Activities (METs) |
|---|---|---|---|
| Class I | Ordinary physical activity does not cause undue fatigue, dyspnea, or palpitations. | None | Carry 11 kg up 8 steps, Shovel snow, Ski, Jog or walk 8 km/h (≤ 7 MET) |
| Class II | Ordinary physical activity causes fatigue, dyspnea, palpitations, or angina. Comfortable at rest. | Mild | Sexual intercourse, Garden, Roller skate, Walk 7 km/h, Climb stairs (≤ 5 MET) |
| Class III | Comfortable at rest; less than ordinary activity causes symptoms. | Moderate | Shower or dress, Make a bed, Clean windows, Play golf, Walk 4 km/h (≤ 2 MET) |
| Class IV | Symptoms occur at rest; any physical activity increases discomfort. | Severe | Cannot complete any activity requiring ≥ 2 MET |
WHO Maternal Cardiovascular Risk Classification
Committee Members
Ashley
Boerrigter
Committee Chair
Maternal Fetal Medicine Specialist
Cheryl Parker
University of Louisville
Director, Nurse Anesthesia Track
Angie Chisholm
Frontier Nursing University
Nurse-Midwifery Faculty
Maureen Marra
Baptist Health of Louisville
James Damron
University of Kentucky
Division Director of Obstetric Anesthesia
Dr. Lindsey D. Neese
Norton Healthcare
Division Director, Maternal Child Health
Kelcey Hall
Humana Healthy Horizons
Care Coach/Care Manager
Susan Owens
University of Kentucky
Tara Purcell
Wellcare Health Plans
OB Care Manager
Elizabeth Matera
St. Claire Healthcare
Director of System Women’s & Children’s Services
Sarah Marks
University of Kentucky
Ellee Adams
St. Elizabeth Healthcare
Director of System Women’s & Children’s Services
Carly Mitchel
Children’s Hospital/Bellarmine University
Anesthesia Program Administrator
Rachel Pokriva
Ayesa Hilvano
St. Elizabeth Healthcare
Guichun Han
University of Pikeville
Mike Turner
American Heart Association
Tracy Monks
American Heart Association
Jennie Morehead
KY Heart Disease Stroke Prevention Task Force
Jamie Kemp
Baptist Health
Lacy Shumway
Kati Heinemann
Liberty Hombe
Tool Citations
mWHO Classification
Citation: Thorne S., Nelson-Piercy C., MacGregor A. et al: Pregnancy and contraception in heart disease and pulmonary arterial hypertension. J Fam Plann Reprod Health Care 2006; 32: 75.
CARPREG II
Citation: Silversides, C, Grewal, J, Mason, J. et al. Pregnancy Outcomes in Women With Heart Disease: The CARPREG II Study. JACC. 2018 May, 71 (21) 2419–2430.https://doi.org/10.1016/j.jacc.2018.02.076
ZAHARA
Citation: Drenthen W., Boersma E., Balci A., et al. and for the ZAHARA Investigators: Predictors of pregnancy complications in women with congenital heart disease. Eur Heart J 2010; 31: 2124.