2025 ESC Guidelines for the management of cardiovascular disease and pregnancy

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Overview

Paper Summary

Conflicts of Interest

Identified Weaknesses

Rating Explanation

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Paper Summary

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Expert Consensus on Heart Care During Pregnancy: Guidelines for a Growing Field

These guidelines provide updated recommendations for managing cardiovascular disease in pregnancy, emphasizing the role of a multidisciplinary Pregnancy Heart Team and individualized care. Many recommendations are consensus-based due to limited randomized trials. They address various cardiac conditions, medications, risk assessment, and long-term post-partum care.

Possible Conflicts of Interest

The guidelines were funded entirely by the European Society of Cardiology (ESC) with no involvement of the healthcare industry. All task force members submitted declarations of interest, available in a supplementary document, but no critical conflicts are immediately apparent.

Identified Weaknesses

Low level of evidence for most recommendations

The majority of recommendations rely on consensus or low-quality evidence due to the scarcity of randomized trials in pregnant women with heart conditions, as highlighted in the guidelines themselves.

Limited generalizability due to data source

The generalizability of the findings may be limited, as most data come from studies conducted in high-income countries.

Limited practical application for non-specialists

The guidelines are extensive and comprehensive, but lack practical guidance for primary care physicians or those without specialized cardiology knowledge.

Rating Explanation

These guidelines provide a comprehensive and valuable update for healthcare professionals managing cardiovascular issues in pregnant women. While the recommendations are predominantly consensus-based due to limited high-quality evidence, the guidelines integrate the latest research and clinical experience, offering a structured approach to care across various cardiac conditions and stages of pregnancy. The guidelines also appropriately address limitations and emphasize the need for future research.

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