Heart conditions in which pregnancy is contraindicated

  • Heart disease is classified into 4 classes based on risk to the mother if she becomes pregnant
  • In patients who are classified under class 4, pregnancy is not advised
  • They should be offered emergency contraception and termination if they become pregnant

Class 4 cardiac conditions:

  • Pulmonary artery hypertension of any cause (such as Eisenmenger complex)
  • Severe systemic LV dysfunction with:
    • NYHA class III – IV
    • LV ejection fraction less than 30%
  • Previous peripartum cardiomyopathy with residual impairment of LV function
  • Obstructive lesion of left heart – aortic or mitral stenosis with valve area less than 1cm2
  • Marfans with aortic root dilatation more than 4cm

Heart disease and pregnancy By Philip J. Steer, Michael A. Gatzoulis, p12

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