|Abstract: ||Aims: 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
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
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.|