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Home/Services/Maternal Cardiac Assessment
A New Standard of Care

Listening to your heart
as carefully as we
listen to your baby's.

Two new techniques developed in our practice allow your obstetrician to measure how your heart and blood vessels are adapting to pregnancy — quickly, safely, and at the very same visit as your ultrasound.

Time Required
Under 5 minutes
Invasiveness
None
When It Helps Most
High blood pressure, growth concerns
Tested In
700+ pregnancies
Why It Matters

Pregnancy is a
heart story, too.

Every pregnancy asks the heart to do extraordinary work. By the second trimester, your heart is pumping roughly 30 to 50 percent more blood than it did before — supporting the placenta, the baby, and you.

When this adaptation goes smoothly, pregnancy unfolds the way it should. But when the heart and blood vessels struggle to keep up, conditions like high blood pressure, preeclampsia, or slowed fetal growth can develop — sometimes weeks before traditional warning signs appear.

"Until recently, the only numbers we routinely measured were blood pressure and pulse. That's like checking the dashboard without ever opening the hood."

The two techniques described here open the hood. They give us a real, gestational-age-specific picture of how your cardiovascular system is performing — and they help us choose the right treatment when it isn't.

The Techniques

Two windows into the
same vital question.

Both methods measure how well your heart is pumping and how your blood vessels are responding. They are complementary — and either can be performed during a routine prenatal visit.

01 Ultrasound Method

The Suprasternal Notch View

A specialized ultrasound, performed at the same visit.

Published in DeVore GR, Polanco B. Assessing maternal cardiac function by obstetricians: technique and reference ranges. American Journal of Obstetrics & Gynecology, August 2023. Read the paper →
CARDIAC Blood flow waveform SUPRASTERNAL NOTCH VIEW Probe location Descending aorta

A small ultrasound probe — the same kind already on the machine that scans your baby — is gently placed in the soft hollow at the base of your neck, just above your breastbone.

From this vantage point, we can actually see the large blood vessel (your aorta) leaving your heart and measure how much blood travels through it with each beat. No needles. No injections. No discomfort.

What makes this approach different: most older methods had to estimate the size of the aorta from your height. Here, we measure it directly — making the results far more accurate and personal to you.

Equipment
Same ultrasound machine
Position
Reclined, pillow under shoulders
Sensation
Cool gel, light pressure
Image Captured
Aortic arch & blood flow
02 Blood Pressure Cuff Method

The Computerized Brachial Cuff

A sophisticated arm cuff that does far more than measure blood pressure.

Published in DeVore GR. Measurements of cardiac function in a prospective cross-sectional study of pregnant women between 10 and 39 weeks of gestation using a computerized brachial blood pressure cuff. Obstetrics & Gynecology International Journal, December 2025. Read the paper →
VICORDER PULSE-WAVE ANALYSIS Brachial pulse → Central aortic pressure PULSE-WAVE ANALYSIS Smart cuff Analyzer

This looks like a familiar blood pressure cuff — but it's listening to something far richer. As the cuff inflates around your upper arm, it captures the precise shape of each pulse wave traveling through your arteries.

From those waves, a computer reconstructs what's happening at the level of your heart and the large vessels leaving it: how much blood you're pumping with each beat, and how much resistance your blood vessels are offering.

What makes this approach special: it works in three positions — lying on your back, lying on your left side, and sitting up — so we can see how your circulation responds to position changes (which especially matters in later pregnancy).

Equipment
Upper-arm cuff & analyzer
Positions
Supine · Left lateral · Sitting
Sensation
Like a standard BP reading
Information Captured
Central aortic pressure & flow
What We Measure

Four windows into how
your heart is adapting.

Both techniques give us four distinct measurements — together, they tell a complete story about your cardiovascular health in pregnancy.

Preload
The Filling

How well your heart fills with blood between beats. Measured by stroke volume — the amount your heart pushes out each beat. A healthy pregnancy needs a strong, well-filled heart.

Afterload
The Resistance

How much your blood vessels resist the flow of blood — your "vascular resistance." If vessels are too tight, the heart has to work harder. This is often the hidden driver of high blood pressure in pregnancy.

Contractility
The Squeeze

How forcefully your heart muscle contracts. This tells us whether your heart is keeping pace with pregnancy's demands — or quietly working too hard.

Blood Flow
The Output

The bottom line — how many liters of blood your heart delivers each minute. This is what reaches your baby through the placenta, and what carries oxygen to every part of your body.

What This Means for You

Right diagnosis,
right medicine.

Not all high blood pressure in pregnancy is the same. Two women with identical blood pressure readings can have very different cardiovascular pictures — and they may need very different treatments.

One woman's heart may be pumping too forcefully; she'll do best with a medicine that calms the heart. Another woman's blood vessels may be too constricted; she'll respond better to a medicine that relaxes the vessels.

Without these measurements, this choice has often been made by trial and error. With them, we can match the medicine to the underlying problem — from the very first prescription.

  • i.
    Earlier insight Cardiovascular changes often appear weeks before traditional warning signs of preeclampsia or growth restriction.
  • ii.
    Personalized treatment Helps us choose between medicines like labetalol and nifedipine based on what your body actually needs.
  • iii.
    Trackable over time Because we use gestational-age-specific reference ranges, your numbers can be followed throughout pregnancy.
  • iv.
    Safe for you and baby Both techniques are completely non-invasive — no needles, no radiation, no medication required.
What to Expect at Your Visit

It fits inside your
regular ultrasound visit.

You don't need a separate appointment, fasting, or any special preparation. Here's how it typically unfolds.

i
Settle in

You rest comfortably while we take routine measurements — height, weight, and blood pressure.

ii
Your ultrasound

We perform your baby's scan as usual, examining growth, anatomy, and well-being.

iii
Heart assessment

A few additional minutes — either the cardiac ultrasound view or the arm cuff measurements, or both.

iv
Results & plan

We review the findings with you the same day and discuss next steps if anything needs attention.

Questions patients ask.

Q.Is any of this uncomfortable or risky for my baby?

Not at all. The ultrasound method uses the same safe sound waves that examine your baby — simply directed at a different spot for a few minutes. The cuff method is exactly like a standard blood pressure reading. Neither technique involves needles, radiation, dyes, or medications.

Q.Why haven't I heard of this before?

Until very recently, this kind of detailed cardiovascular assessment in pregnancy required a cardiologist, specialized echocardiography, or dedicated standalone devices — none of which fit easily into routine obstetric care. The techniques described here were developed specifically to bring this evaluation into the obstetrician's office, using equipment we already have.

Q.Who should consider this assessment?

Anyone with high blood pressure (whether before or during pregnancy), a history of preeclampsia, a baby measuring smaller than expected, or other complications that may involve the cardiovascular system. It can also offer reassurance in healthy pregnancies, by confirming that your heart is adapting normally.

Q.How accurate are these measurements?

Both techniques were validated against established methods in studies of hundreds of pregnant women. The results closely match those obtained with more elaborate technologies — and in some respects (like directly measuring your own aortic diameter rather than estimating it), they are more personalized.

Q.Will this change my care?

In some cases, yes. The findings can influence which blood pressure medicine is recommended, how closely we monitor you and your baby, and how we time interventions. In many cases, the assessment simply provides reassurance. Either way, you and your obstetrician will have better information to make decisions together.

Q.Do I need to do anything to prepare?

Nothing special. Wear comfortable clothes that allow easy access to your upper arm (for the cuff method) and your upper chest/neck area (for the ultrasound method). You don't need to fast, change medications, or arrive earlier than your usual appointment.

Every pregnancy
deserves a full picture.

If you'd like to learn whether one of these assessments would be useful in your care, please ask at your next visit — or contact our office to schedule a consultation.

Greggory R. DeVore, MD
Fetal Diagnostic Centers · Pasadena & Lancaster, California