The American College of Cardiology (ACC) recently released an expert consensus decision pathway, Optimization of Postpartum Care for Patients with and at Risk for Premature and Long-Term Cardiovascular Disease. The new ACC clinical guidance is a strategic resource for clinicians looking to optimize postpartum care for patients who are at risk for cardiovascular disease (CVD).

Today, we’re looking at the components outlined in the guidance as the keys to optimizing postpartum maternal cardiovascular health. For a complete look at the following key elements, along with the most thorough explanation of the guidance statements, view the full-text version. 

Key Elements of the ACC Postpartum Care for Premature and Long-Term Cardiovascular Disease Guidance:

Prior to Hospital Discharge

  • The ACC recommends educating patients regarding cardiovascular red flags, providing guidance on achieving blood pressure goals, and providing follow-up care recommendations.
  • Multidisciplinary coordination, lactation support, a mental health assessment, identifying cardiovascular red flags, and trauma-informed care are all crucial elements during this window.
  • A safe discharge checklist is recommended, along with coordinating an individualized follow-up plan, ensuring the patient has a home blood pressure cuff, and that they understand the aforementioned patient education components. 

Early Postpartum

  • The ACC recommends educating patients during this phase regarding ongoing cardiovascular red flags, maintaining blood pressure goals, and medication safety.
  • Early blood pressure assessment and remote blood pressure monitoring are beneficial, as is lactation support and screening for cardiovascular red flags.

Later Postpartum

  • The ACC recommends a comprehensive cardiometabolic, diabetes, hypertension, lipid, and obesity screenings, along with lifestyle modification relating to nutrition, physical activity, sleep, and tobacco use.
  • Providing ongoing location support and mental health assessments are beneficial, along with contraception counseling and interpregnancy optimization. 
  • Patient education regarding long-term ASCVD risk, future pregnancy risk, and health optimization are recommended during this window.

Transition to Longitudinal Care

  • During this period, the ACC recommends patients reestablish care with their primary care provider and communicate related obstetric health history.
  • At this point, clinicians can help patients identify and troubleshoot social barriers precluding care, assist in interconception planning and optimization, and optimize lifelong cardiovascular risk factors.
  • Patient education, at this time, should include ongoing interpregnancy optimization and ASCVD risk reduction.

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