Management of valvular heart disease during pregnancy.

Heart disease complicates approximately 0.4-4% of all pregnancies. 1-5 Presence of significant heart diease during pregnancy is a high risk situation; it increases the risks of adverse maternal and fetal outcome. Despite advances in the management of maternal cardiovascular diseases, heart disease during pregnancy accounts for as much as one-third of the maternal mortality. 6 Furthermore, about 20% of the pregnancies in the presence of valvular heart disease are associated with poor neonatal outcomes. 7,8 With the declining incidence of rheumatic fever and the significant advances in the management of congenital heart disease, the ratio of rheumatic heart disease to congenital heart disease in pregnancy has decreased to approximately 1:3 in other parts of the world. Rheumatic heart disease is still the most common heart disease complicating pregnancy in our country. 5,9 In this article, we reiterate the salient aspects of