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

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