title: The contribution of heart disease to maternal mortality.
abstract: OBJECTIVE
  Heart disease is a leading cause of maternal death worldwide. In western countries, the principal causes of death from heart disease are myocardial infarction, cardiomyopathy and congenital heart disease, whereas in developing countries, rheumatic heart disease and its long-term consequences are more important.
  
  
  RESULTS
  There are few prospective studies upon which to base the management of these complex cases. However, best practice includes the assessment of women prepregnancy by a multidisciplinary team, with the aim of optimizing the clinical state, changing therapy to avoid teratogenic treatments and advising the patient and her relatives about the potential risks and possible complications that may arise. During pregnancy, the multidisciplinary team should define the level of care/surveillance required in each case. Some women may be safely looked after in a peripheral hospital, whereas others may need to be seen by the multidisciplinary team in the tertiary centre at regular intervals along with close echocardiographic monitoring.
  
  
  CONCLUSIONS
  The majority of women with preexisting heart disease can go through pregnancy safely, however, close attention to detail must be paid to avoid potential complications.
authors: Academic Obstetrics and Gynaecology, Imperial College bInstitute for Women's Health, University College London, London, UK.
authors: Julia
authors: J
authors: Zöllner
authors: Ruth
authors: R
authors: Curry
authors: Mark
authors: M
authors: Johnson
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D009202:Cardiomyopathies / Q000401:mortality* / Q000628:therapy; D004452:Echocardiography / Q000379:methods; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality* / Q000628:therapy; D006801:Humans; D033183:Interdisciplinary Communication; D008428:Maternal Mortality; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy; D009765:Obesity; D010348:Patient Care Team; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000401:mortality* / Q000628:therapy; D012214:Rheumatic Heart Disease / Q000401:mortality* / Q000628:therapy; D018570:Risk Assessment; D015607:Stents
chemical_list: D000925:Anticoagulants