2025 ESC Guidelines for the management of cardiovascular disease and pregnancy

Cardiovascular disease (CVD) is a major cause of maternal mortality and morbidity. With these new Guidelines we wish to provide updated evidence-based guidance for patients and caregivers. Reducing maternal mortality and morbidity is a key priority of the World Health Organization (WHO). In managing maternal and foetal health, it is essential to balance the risks and benefits of maternal and foetal therapeutic needs. Due to the scarcity of prospective or randomized studies within this field, which often cannot be performed for ethical reasons, most recommendations in these Guidelines are based on evidence level C. Consequently, there is an ongoing need for more registries, such as the Registry of Pregnancy and Cardiac Disease (ROPAC) and the European Surveillance of Congenital Anomalies network, and prospective studies to enhance our understanding in this area.