Johnson, MarkCurry, RuthRuthCurry2017-03-022017-02-282017-03-022014-09almahttp://hdl.handle.net/10044/1/44495Aims: To study the effect of pre-existing maternal cardiac disease on cardiovascular function during pregnancy, and on obstetric and fetal/neonatal outcomes, and to investigate maternal risk factors for adverse events. Methods: Retrospective case note review. Results: Four hundred and eighty-nine pregnancies in 326 women were studied. Most pregnancies (50%) occurred in women with congenital heart disease. There were 4 maternal deaths, 6 stillbirths and 5 neonatal deaths. Cardiovascular events occurred in 7.4% of pregnancies, while obstetric and perinatal complications occurred in 34% and 30% of pregnancies respectively. Conclusions: Pregnancy in women with pre-existing heart disease continues to be associated with high rates of maternal and neonatal mortality and morbidity. This work highlights the importance of effective prepregnancy counselling and meticulous surveillance during pregnancy, delivery and the puerperium by an experienced multidisciplinary team. Additionally there is an urgent need for well-designed randomisedcontrolled trials to determine best practice.Thesis or dissertationhttps://doi.org/10.25560/44495