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Cardiac Conditions

in Obstetric Care


Cardiac conditions are the leading cause of pregnancy-related deaths and disproportionately affect non-Hispanic Black people. Nationally, multidisciplinary maternal mortality review committees have found that birthing people who died from cardiac conditions during pregnancy and postpartum were not diagnosed with a cardiovascular disease prior to death.  These committees also found that more than 80% of all pregnancy-related deaths were preventable, regardless of cause.

Intro
PROJECT APPLICATION
Project AIM
QI Project Guidance & Resources
Hospital Teams

Intro

Obstetric complications such as preeclampsia and gestational diabetes are associated with future cardiovascular disease (CVD) risk. Studies show that those with cardiac risk factors and those with congenital and acquired heart disease require specialized care during pregnancy and postpartum to minimize risk of preventable morbidity and mortality. Common risk factors for CVD-related mortality include race and ethnicity, age, hypertension during pregnancy, and obesity.

TIPQC will implement the ACOG AIM Cardiac Conditions in Obstetric Care Quality Improvement bundle. This project will focus on decrease Severe Maternal Morbidity Among People with Cardiac Conditions & Decrease Pregnancy-Related Deaths Due to Cardiac Conditions (state surveillance monitoring) by 10% across the state by Summer 2026, while improving care of patients with cardiac conditions in hospitals and acute care setting by increasing screening and appropriate referrals for at least 90% of all birthing people thereby reducing NTSV c-sections & reduce preterm rates by 10% by June 2026.

Project

Application

The following application components must be completed before your project team will be approved to participate in this inter-institutional QI project:

It should be noted that execution of the TIPQC Participation and Data Use Agreement (DUA) with TIPQC is required prior to approval of your facility for this project application. Many facilities have already completed this step. It is only required once and is applicable to all projects. It is recommended that the “day to day” project team member (i.e. key contact person) complete this application.

Apply
Designate key project team members
Designate data access rights
Designate additional project team members
Obtain necessary signatures

Project Aim

Global AIM:

Decrease Severe Maternal Morbidity Among People with Cardiac Conditions & Decrease Pregnancy-Related Deaths Due to Cardiac Conditions (state surveillance monitoring) by 10% across the state by Summer 2026.

Statewide AIM:

Improve care of patients with cardiac conditions in all participating hospital and/or urgent or emergency care setting by increasing screening and appropriate referrals for at least 90% of all birthing people thereby reducing NTSV C-sections & reduce preterm rates by 10% by the June 2026.

QI Project

Guidance & Resources

QI Project Guidance

Key Driver Diagram

Download
QI Project Guidance

Tool kit

Download
QI Project Guidance

Protocol

Download
Resources

Statewide IRB Approval

Download
Resources

Data Paper Form – Quarterly

Download
Resources

Data Paper Form – Monthly

Download
Resources

EMR Guide

Download
AIM Resources

Video

Access
AIM Resources

AIM Bundle & Additional Resources

Access
Project Resources

Ask About Aspirin Preeclampsia Foundation

Access
Project Resources

Eclampsia Algorithm ACOG

Download
Project Resources

Cardiovascular Disease in Pregnancy & Postpartum ACOG

Download
Project Resources

OB Emergency Pregnancy Status Sign ACOG

Download
Tools

Project Flyer for Providers

Download
Tools

Project Flyer for Patients

Download
Tools

Dr. Hameed Talk

Access
Tools

HeART Pocket Card for Patients

Download

High-Risk Heart Disease in Pregnancy- Elkayam, U et al. JACC

Download

Participating

Hospital Teams

* Denotes Pilot Hospital

State Project Leaders

Connie Graves, MD and Lynlee Wolfe, MD both Maternal Fetal Medicine specialists are the leaders of this project. 

Dr. Graves has been involved with TIPQC since its inception and will serve as the TIPQC Maternal Medical Director in 2024-26.  Dr. Graves is the Medical Director, Tennessee Maternal Fetal Medicine, Director of Perinatal Services, St. Thomas Health, Co-Director of the Comprehensive Perinatal Cardiac Clinic, St. Thomas Health, Professor – University of Tennessee, Clinical Professor – Vanderbilt University, and Adjunct Professor – Meharry Medical College.  She also serves on many state and national boards and is widely published. 

Dr. Wolfe is an Assistant Professor in the Division of Maternal-Fetal Medicine at the University of Tennessee.

Get

Involved.

TIPQC is actively recruiting devoted health care professionals, community leaders and patient and family partners to further our mission of improving health outcomes for mothers and babies in Tennessee.

Learn How