Rationale and Need for Cardio-Obstetric Care Units

Abstract

Cardiovascular diseases, especially rheumatic heart disease (RHD), are a leading cause of maternal morbidity and mortality in Egypt, where fragmented care and limited specialist access heighten pregnancy risks. General obstetric units often lack the expertise to manage complex heart conditions, leading to delayed diagnosis, inadequate treatment, and preventable adverse maternal and fetal outcomes. 

The Aswan Heart Centre’s cardio-obstetric care (CO-care) program addresses this gap by integrating cardiology, obstetrics, and nursing to deliver protocol-driven, risk-stratified care for high-risk pregnancies, focusing on early detection and management of primary and secondary cardiovascular complications during and after pregnancy. 

Pregnant females with primary cardiovascular complications of pregnancy or history of pre-existing cardiovascular disease and/ or intervention are accepted both on self-referrals and referrals from other healthcare providers, offering long-term follow-up and maintaining a registry to track outcomes and late cardiovascular complications. 

Key implementation steps include raising provider awareness to patients and health care providers, standardizing protocols, ensuring access to counseling and specialized diagnostics, and building referral networks. Expected outcomes are improved maternal survival, reduced preterm births, and a scalable, sustainable model for cardio-obstetric care that can be adapted in other low- and middle-income countries facing similar challenges.