ABSTRACT
Introduction Maternal mortality and morbidity remain important health risks for childbearing-aged women. Globally, for women aged 15-49 years, 7.3% of all deaths are related to maternal causes.1 Hemorrhage, sepsis, hypertensive disorders, and comorbid conditions such as obesity and diabetes mellitus continue to be significant contributors to maternal mortality. But demographic shifts and improved care for women with congenital heart disease have led to an increased influence of cardiovascular disease on maternal morbidity and mortality. Data from the Centers for Disease Control and Prevention in the United States demonstrated that in the surveillance period encompassing 2006-2009, cardiovascular conditions alone accounted for over one-third of all pregnancy-related deaths.2 Further, assessment of near-miss maternal mortality during pregnancy and childbirth found that the leading intensive care unit admission diagnosis for pregnant and postpartum women was maternal cardiac disease.3 In another study, 55% of the patients with cardiovascular disease had valvular heart disease, congenital heart disease, Marfan syndrome, or pulmonary hypertension.4
