Risks of Pregnancy in Women With Cardiac Disease

PREVENTIVE cardiology includes not only prevention of development of cardiac disease but also steps to delay progression of existing cardiac conditions, prevention of associated complications, and preservation of cardiac reserve. The cardiologist should provide counsel to patients with cardiac disease regarding occupation, recreational activities, place of habitation, and other environmental factors. A major aspect of preventive cardiology is counseling young women with cardiac disease regarding childbearing. In the absence of a sound data base, it is impossible to provide statistically valid figures regarding the increment of risk of pregnancy for each situation, but a reasonable set of guidelines can be developed for various cardiac lesions affecting women of childbearing age. To provide prepregnancy counseling we need to know (1) the degree of increased cardiac workload as well as other hemodynamic alterations occurring during normal pregnancy, (2) the complications of pregnancy relevant to cardiac disease, and (3) the natural history of