Pursuing safer pregnancies
May 19, 2016
As national leaders in maternal-fetal
medicine, UCI Health
researchers are spearheading
projects in cardiovascular disease and
preeclampsia that promise to make
pregnancy and childbirth healthier and
safer for both mother and baby.
A soon-to-be released toolkit aims to
help expectant women and their doctors
identify previously undiagnosed heart
conditions during pregnancy and following
The toolkit is the result of work
by the California Maternal Quality Care
Collaborative cardiovascular committee
chaired by Dr. Afshan Hameed, a UC Irvine
Health professor of cardiology and maternal-fetal
medicine, that seeks to understand and
address a three-fold rise in pregnancy-related
deaths statewide recorded from 1996 to 2007.
The 20-member California Pregnancy
Associated Mortality Review Committee
identified heart disease as the No. 1 cause of
death in pregnancy after reviewing pregnancy-related
deaths from the years 2002 through
2006. More than 95 percent of the women who
died were unaware they had heart conditions.
The toolkit algorithm alerts physicians
to undiagnosed heart disease—symptoms
that often mimic the normal symptoms of
pregnancy, particularly in the last trimester,
such as shortness of breath, fatigue and
lower extremity swelling.
“Almost nine out of 10 mothers who died
would have been alerted as having a high-risk
heart condition if their healthcare providers
had applied the knowledge that our team has
put together in this toolkit,” says Hameed,
who also serves as UCI Health director of
obstetrical services and of quality and safety.
The toolkit will be available to all obstetrics
providers in California and across the nation
who care for pregnant women. Patient
education materials to raise awareness among
pregnant women are also part of the toolkit.
UCI Health physicians have been
involved with the broader California
Maternal Quality Care Collaborative since
its formation in 2007. The organization is
developing toolkits to improve care for
other conditions that can increase the risk of
maternal death, including hemorrhaging.
UCI Health maternal-fetal health
experts are also focused on preeclampsia, a
complication of pregnancy characterized by
high blood pressure, protein in the urine and
swelling. It’s usually diagnosed in the last
trimester of pregnancy and affects 6 to 7
percent of women.
The condition can be life-threatening to both
mother and baby. Its causes remain unknown,
and the only known way to halt the illness is to
deliver the baby—frequently prematurely.
“Because of this, obstetricians are often
faced with a dilemma in balancing the
mother’s health against the baby’s health,”
says Dr. Deborah Wing, a UCI Health
professor of obstetrics and gynecology.
“The complications of prematurity are many
and include chronic lung disease, blindness,
deafness and neurodevelopmental delay.
About 15 years ago the nationwide cost of
prematurity was estimated at $26 billion
a year. Adjusted for inflation, it’s certainly
much higher today.”
Wing is the lead investigator of the
nationwide PRESERVE-1 clinical trial to assess
the safety, efficacy and pharmacokinetics of
an anticoagulant drug called antithrombin in
treating early-onset preeclampsia. Researchers
recently enrolled 120 women at trial sites
nationwide, including UC Irvine Medical Center.
“In my 20-year-plus career in high-risk
obstetrics, this trial offers the best promise
for prolonging the pregnancies of women
with preterm preeclampsia of anything I’ve
seen,” Wing says. “UCI Health patients
enrolled in the trial will play an important
role in advancing much-needed research
that may help determine whether this drug
is a potential treatment.”
UC Irvine Medical Center has one of
California’s few combined regional perinatal/neonatal programs to treat high-risk
pregnancies, deliveries and newborns.
Learn more about
maternal-fetal health at
— UCI Health Marketing & Communications
Featured in UCI Health Live Well Magazine Summer 2016