Management of heart disease in pregnancy.

Cardiac disease in pregnancy is the most important non-obstetric cause of maternal death; such patients should be assessed by a cardiologist before considering pregnancy. Once pregnant, the patient is managed by a combined cardiac and obstetric team familiar with the special risks associated with heart disease in pregnancy. Delivery should be undertaken in a hospital equipped with specialist cardiac, anaesthetic and obstetric facilities. If the patient cannot be expected to survive in good health, puerperal sterilization is advised.