Abstract
The haemodynamic changes of pregnancy can have a negative impact on maternal cardiac health, especially in women with pre-existing cardiac disease. In the most recent Confidential Inquiries into Maternal Mortality in the United Kingdom, heart disease was found to be the most common indirect cause of maternal death during pregnancy.1 Pregnancy counselling and management for women with heart disease is being increasingly recognized as an important aspect of their overall cardiac care. With increasing awareness, there has been a growing body of research focused on pregnancy outcomes and risk stratification. There have also been new initiatives to improve clinical care, such as the 2011 European Society of Cardiology (ESC) guidelines on the management of cardiovascular disease during pregnancy.2 While our current understanding of pregnancy risk assessment and management has improved over the past 20 years, many questions can only be answered by collaborative efforts.