Recommendations Developed for Managing Heart Failure in Pregnancy

WEDNESDAY, Oct. 15, 2025 (HealthDay News) — Recommendations have been developed for managing heart failure in pregnancy and published online Sept. 22 in a Society for Maternal-Fetal Medicine Consult Series in Pregnancy.

Afshan B. Hameed, M.D., from the University of California, Irvine, and colleagues provided guidelines for patients with heart failure with reduced ejection fraction who are continuing pregnancy.

The authors noted that all patients with right heart failure due to pulmonary arterial hypertension should receive counseling about high rates of maternal morbidity and mortality; they should be referred to a center with expertise in this condition to guide management. Referral to a genetics provider with expertise in heritable cardiac disease should be considered for people with peripartum cardiomyopathy, especially when the index of suspicion is high. Starting or continuing guideline-directed medical therapy is recommended when medically able for patients with chronic left ventricular failure. When maternal heart failure is a result of an underlying congenital cardiac defect, fetal echocardiography is recommended. Serial growth ultrasounds are recommended in pregnancies complicated by maternal heart failure. For pregnant patients with heart failure, continuous fetal heart rate monitoring during anesthesia administration, labor, and delivery is recommended. Continuous or intermittent fetal heart rate monitoring is recommended in the case of maternal cardiovascular changes prompting inpatient assessment or treatment. Postpartum patients with heart failure should undergo routine counseling regarding infant feeding.

“Getting accurately diagnosed and treated for heart disease, either before pregnancy or early in pregnancy, is both life-prolonging and life-changing if caught early,” coauthor Arthur Jason Vaught, M.D., from Johns Hopkins Medicine in Baltimore, said in a statement.

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