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Updated: Jun 29, 2026
Assessment of Maternal Vascular Remodeling During Pregnancy in the Mouse Uterus
Published on: December 5, 2015
Practical assessment of maternal cardiovascular risk in pregnancy
Nazanin Moghbeli1, Emmanuelle Pare, Gary Webb
1Cardiovascular Division, Philadelphia Congenital Heart Center, University of Pennsylvania, Philadelphia, PA, USA.
Insights
Pregnancy poses significant cardiovascular risks for women with heart disease, increasing the likelihood of heart failure and death. Pre-conception risk assessment is crucial for improving maternal and fetal outcomes in these high-risk pregnancies.
Area of Science:
- Cardiology
- Maternal-Fetal Medicine
- Reproductive Health
Background:
- Cardiovascular disease is a leading cause of maternal mortality globally.
- Increased survival of congenital heart disease into adulthood necessitates understanding pregnancy risks.
- Pregnancy exacerbates hemodynamic stress, elevating risks for women with pre-existing heart conditions.
Purpose of the Study:
- To describe the process of assessing pregnancy-associated cardiovascular risks in women with structural heart disease.
- To review current literature on pregnancy risks across various cardiac conditions.
- To suggest an approach for risk stratification in pregnant women with heart disease.
Main Methods:
- Systematic review of current literature on pregnancy risks in women with structural heart disease.
- Analysis of risks associated with complex congenital lesions, valvular heart disease, cardiomyopathy, and aortopathy.
- Identification of features associated with adverse maternal and fetal outcomes.
Main Results:
- Poor functional status, prior heart failure, arrhythmias, or cerebrovascular events are risk factors.
- Cyanosis, poor ventricular function, and severe valve stenosis increase maternal and fetal risks.
- Pulmonary hypertension and Eisenmenger syndrome indicate extremely high risk, including mortality.
Conclusions:
- Systematic pre-conception risk assessment is essential for optimizing outcomes in pregnant women with heart disease.
- Identifying specific risk factors allows for targeted management strategies.
- Risk stratification is key to improving maternal and fetal survival in high-risk pregnancies.
Abstract:
Cardiovascular disease in pregnancy is the most common cause of maternal mortality in the developed world and an important cause of heart failure, stroke, and arrhythmia. As more children with congenital heart disease survive into adulthood, there is a more pressing need to understand the risks that pregnancy poses for these women. Pregnancy, labor, and delivery increase the hemodynamic stress on the cardiovascular system and place women with heart disease at increased risk of cardiovascular complications, which include heart failure and death. Systematic assessment of pregnancy risk in these women, ideally before conception, is essential in optimizing maternal and fetal outcomes. This article describes the process of assessing risk of pregnancy-associated cardiovascular complications in women with structural heart disease. We review the current literature on pregnancy risk in women with complex congenital lesions, valvular heart disease, cardiomyopathy, and aortopathy, and suggest an approach to risk stratification. Based on a review of the literature, we report features that pose an increased risk of adverse maternal and fetal outcomes, which include poor maternal functional status; prior history of heart failure, arrhythmia, or cerebral vascular events; cyanosis; poor systemic ventricular function; and severe aortic or mitral stenosis. Pulmonary hypertension and Eisenmenger syndrome place women at exceedingly high risk for cardiovascular complications in pregnancy, including maternal and fetal death.
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