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Poster Session 1

Category: Medical/Surgical/Diseases/Complications

Poster Session 1

(326) Preconception Counseling with a Multidisciplinary Cardio Obstetrics Team: What does it look like?

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Rachel L. Wiley, MD, MPH (she/her/hers)

Maternal Fetal Medicine Fellow
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States

Coauthor(s)

FA

Fayad Ammar, MBBS

Division of Cardiovascular Medicine, Department of Internal Medicine, University of California San Diego
San Diego, California, United States
SW

Shayna Weinstein, MPH

New York Medical College, Valhalla, NY
Valhalla, New York, United States
LT

Lauren Tsai

Division of Cardiovascular Medicine, Department of Internal Medicine, University of California San Diego
San Diego, California, United States
CS

Cameron Salehi, MPH

Medical Student
University of California San Diego School of Medicine
San Diego, California, United States
EG

Erin Gallent, MD, PhD

Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
Minhazur R. Sarker, MD

Fellow Physician
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States
LA

Laith Alshawabkeh, MD

Associate Professor
Division of Cardiovascular Medicine, Department of Internal Medicine, University of California San Diego
San Diego, California, United States
MT

Maryam Tarsa, MD

Professor
Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Diego
San Diego, California, United States

Objective:
Preconception counseling (PCC) is a critical component of cardiac care for reproductive-age individuals, yet estimates are only 1 in 10 at risk people receive PCC. This study aimed to characterize the delivery of PCC within a tertiary care center with a cardio-obstetrics team.

Study Design:
We conducted a retrospective cohort study of pregnant patients co-managed by a multidisciplinary cardio-obstetrics team at a single tertiary institution between 2020 and 2024. Inclusion criteria were nulliparous with pre-existing cardiac disease, who established care prior to conception. PCC was defined as either a visit documenting discussion of pregnancy risks or avoidance of pregnancy with a MFM specialist or cardiology. Demographic data was collected, along with information on the content of PCC counseling.

Results:
Of 198 pregnancies reviewed, 87 (51.4%) met inclusion criteria. Among these, 48 patients (55.2%) received PCC: 14 (29.2%) from both MFM and cardiology, 27 (56.3%) from cardiology alone, and 7 (14.5%) from MFM alone. Patients who received PCC were more likely to have private insurance (p=0.04), higher pre-pregnancy BMI (p=0.02), and valvular disease (p=0.01, Table 1). While overall cardiac risk stratification did not differ between those who did and did not receive PCC, patients with lower WHO or CARPREG II risk stratification were more frequently seen by cardiology than MFM (Table 2). MFM was more likely to recommend aspirin, genetic counseling, and prenatal vitamins, whereas cardiologists more often advised delaying pregnancy or updating imaging.

Conclusion:
This study provides unique information about the real-world delivery of cardiac PCC, indicating that inclusion of MFM increased discussion of pregnancy-specific care. A multidisciplinary specialty team significantly increased rates of PCC, but still only half of eligible patients received PCC. These findings underscore the need for structured, multidisciplinary approaches to ensure equitable, comprehensive reproductive counseling and identifies gaps, especially in managing lower-risk patients.