ABSTRACT
In the 1994-1996 Confidential Enquiry into Maternal Deaths (CEMD), 39 of the indirect deaths were due to cardiac disease. Ten of these were in congenital cardiac conditions and 29 in acquired conditions. Cardiac disease can be adversely affected in a predictable way by pregnancy or can worsen unexpectedly. Of the maternal deaths in those with congenital cardiac disease, six were due to primary pulmonary hypertension which worsens predictably. Three of these deaths were related to termination (one of these may have been related to pulmonary embolus). Other congenital cardiac causes were hypertrophic obstructive cardiomyopathy, aortic valve disease with endocarditis and anomalous coronary arteries. Antibiotic prophylaxis is important in the presence of valvular disease or a prosthesis. Acquired cardiac causes of death include myocardial infarction, cardiomyopathy, thrombosed mitral valve and pericarditis.
