| Abstract: | The 2019 MBRRACE-UK report highlighted the prevalence of cardiac disease amongst pregnant women, and its role as a driver in maternal mortality. Advancing maternal age, a rise in cardiovascular co-morbidities, and the improvements in congenital heart disease care have all contributed to this static prevalence, despite improvements in obstetric and cardiac care. In this review we consider the importance of pre-conception counselling for women with known heart disease, review the physiological changes of pregnancy which place increased demand on the cardiovascular system, and explore maternal risk, from a cardiovascular perspective. Contemporary management of women with moderate to severe heart disease during pregnancy should be delivered by the pregnancy heart team, a term coined by the European Society of Cardiology in its 2018 guidelines. Individualized care empowers trust and shared decision making and early access to multidisciplinary care is vital in optimizing maternal and fetal outcomes. |
