Poster Session 1
Lilly Liu, MD, MPH
Columbia University Irving Medical Center/NewYork-Presbyterian
New York, New York, United States
John Perino, MD
Columbia New York Presbyterian
New York, NY, United States
Anita Lasala, MD
Columbia New York Presbyterian
New York, New York, United States
Jason D. Wright, MD
Professor of Obstetrics and Gynecology
Columbia University Irving Medical Center
New York, New York, United States
Jennifer Haythe, MD (she/her/hers)
Columbia New York Presbyterian
New York, New York, United States
Sonia Tolani, MD
Columbia New York Presbyterian
New York, New York, United States
Mary E. D'Alton, MD
Obstetrician and Gynecologist-in-Chief
Willard C. Rappleye Professor and Chair
Columbia University Medical Center
New York, New York, United States
Stephanie Purisch, MD
Assistant Professor of Obstetrics & Gynecology
Columbia New York Presbyterian
New York, New York, United States
The objective of this study is to investigate the utility of screening maternal echocardiograms for the diagnosis of incidental cardiac abnormalities in pregnancy in women of advanced maternal age.
Study Design: This is a retrospective study examining the diagnosis of incidental cardiac abnormalities and associated pregnancy outcomes in women over the age of 40 who received screening maternal echocardiograms for the sole indication of advanced maternal age at a single academic institution from 2020-2023. Clinical outcomes included significant incidental cardiac findings on echocardiogram, including decreased left ventricular ejection fraction (LVEF < 55%), moderate to severe valvular disease, diastolic dysfunction, abnormal left ventricular end diastolic diameter (LVEDD > 50mm), and elevated pulmonary artery systolic pressures (PASP > 30mmHg); as well as whether these findings necessitated referral to cardiology or initiation of cardiac medications, and whether they were associated with adverse cardiovascular outcomes.
Results: A total of 27 women met inclusion criteria during the study period. The LVEF was normal for all women in the study, which ranged from 55-70%. Incidental cardiac findings included mild valvular disease in 30% of cases (with no cases of moderate or severe valvular disease), left ventricular hypertrophy in 11% of cases, and elevated PASP >30mmHg in 27% of cases. None of these women experienced adverse cardiovascular outcomes such as postpartum cardiomyopathy, pulmonary edema, maternal ICU admission, or maternal or neonatal death as a result of these findings.
Conclusion: Screening maternal echocardiograms for the sole indication of advanced maternal age in women with no prior cardiovascular history did not result in significant cardiac findings that changed clinical management or affected maternal or neonatal outcomes. Thus, it may be more cost effective to use validated screening tools such as the California Cardiovascular Disease screening algorithm for pregnant and postpartum women to identify those at highest risk for cardiovascular complications in pregnancy.
