Pregnancy and heart disease: An overview

Heart disease has been the overall leading cause of maternal death in the UK for the last six years of reporting. It is particularly concerning that half of those who died in the last three-year period had received substandard care. This article aims to provide readers with a broad overview of the haemodynamic changes of pregnancy and an awareness of the issues women with various cardiac conditions face in pregnancy. The early identification of women at risk is important to optimize the chances of a successful pregnancy. Preconception counselling and contraceptive advice should be offered to encourage informed decision-making and planned pregnancies. Follow-up during pregnancy should be tailored to the degree of assessed risk. There is very little evidence on which to base practice. Practitioners are therefore reliant on clinical experience, small case series and expert consensus. Management of women with pre-existing or acquired heart disease should therefore have input from a consultant with an interest in maternal cardiology and an expert multidisciplinary team.