It’s very risky for patients to have any kind of any other disease when pregnant. These are usually described as high risk conditions because it’s at this time that there is marked morbidity and mortality. It’s been recommended that these occurrences be managed by use of multidisciplinary methods which will optimize care for those suffering from such cases. Risk stratification should also be conducted to enhance prognosis of the pregnant women which heart disease. Pregnant women with cardiac heart disease can gain from the OB/GYN by getting specialized service from the care providers. It’s usually recommended that a fetal echocardiogram be taken to check on the heart of the fetus so as to be able to detect any problem early enough and professional care be given. Pregnancy initially is known to be able to cause remarkable reversible change in the cardiovascular system of a woman.

Alternative Approach

The healthcare system is usually faced with dilemmas most of the time about certain issues some of which even spark controversy. In the event a patient is a high-risk obstetric in the emergency room with congestive heart failure, the experts can be very hard to handle when you are a nurse. In this case an OB/GYN physician team wants the pregnant woman admitted to the Obstetrics unit, and requests that the cardiologists insert the SwanGanz and central venous lines in the Obstetrics area. The cardiologists want the woman admitted to the Cardiac Care Unit (CCU), and request that the OB/GYN physicians monitor the fetus and the mother in the CCU.

The alternative way out is to admit the patient in the intensive care unit where the obstetrician – gynecologist and the cardiologist can do their monitoring without any of them pressuring the other over anything. Basically, the obstetricians, gynecologists and cardiologists are supposed top be very active in preventive medicine rather than emergency rooms (Wenger et al 1996).


However they still have a job to do when there are emergencies like the presented case.

The rationale of doing this is that it will enhance the patient’s access to medication and remove supposed barriers like conflicts and it’s also crucial to the improvement of health of the mother and the fetus. When integrated services are addressed this way, there is continuity of service and it will promote easy and first contact. From previous studies, there is so much satisfaction and compliance from the part of the patient. This usually will translate to compliance with medication, and reduce hospitalization and the use of the emergency rooms.

Facing Challenge

Many women use obstetrician and gynecologist services all over the world as a primary care especially when they reach the most important part of life the reproductive ages. The provision of these services is hence very critical. The major barrier is the understanding of the relationship between gynecology, obstetrics and cardiology. Its common to find pregnant women suffering from cardiac heart diseases as well. This is something that is triggered due to their gender orientation and hormonal influence that results. Having the conflict of observing the patient and where to admit her is very unprofessional (Rich-Edwards et al (1995)..

It’s very evident that the gynecologist, obstetrician and at times the cardiologists are the first to attend to cases of emergencies when pregnant women are admitted to the facility. It’s proper for the experts to work together in order to enhance delivery of appropriate services since these experts could be the most consistent and the only healthcare contact that attend the women. They have that chance to diagnose, treat and assist patient manage their anxiety (Wenger et al 1996). For the same reasons, it’s imperative to expand the vision of the providers that just reproduction so that other issues like cardiac problems are also addressed since they also affect women inexplicably.


All professionals should hence be dedicated to delivery of integrates care and even bio-psychosocial systems. There is also need to develop and in-depth analysis to offer in-depth comprehension of each others duti4es as case providers (in this case The OB/GYN physician in Obstetrics unit and cardiologists in the Cardiac Care Unit CCU) and allow collaboration or working as a team towards patient service satisfaction.


The healthcare system has been very dynamic over the past few years. The integrated healthcare system in particular has undergone radical changes. It’s sometimes known as multi-care treatment, it’s intended to concentrate in the convenience of the patient and simplify the work through the system. Such systems incorporate a variety of diverse medical services. Through this, the healthcare is coordinated, comprehensive and efficient. In order to ensure that this goal is fulfilled in the obstetrics when the mother is suffering from CHD as well, the healthcare providers should be capable of accomplishing the needs of the system. Cardiologists, obstetricians and gynecologists are very important in the implementation of the systems.


1. Pillitteri A. (2007). Maternal & child health nursing— care of the childbearing & childrearing family. Lippincott Williams & Wilkins

2. Porter M.E & Teiberg E.O. (2006). Redefining health care: creating value-based competition on results. Harvard Business Press

3. Rich-Edwards J.W et al (1995). The Primary Prevention of Coronary Heart Disease in Women. The New England Journal of Medicine. Vol. 332: 1759 -1767. No 4.


4. Wenger N.K, Speroff L, & Packard B. (1996). Cardiovascular Health In Women. The New England Journal of Medicine. Vol. 332: 1759 -1767. No 4.