Congenital Hf#,E!rt Disease and Pregnancy

Pregnancy, labor, and delivery appear to be well tolerated in most patients with mild-to-moderate congenital heart disease (CHD). The management of these patients is uneventful. Patients with more severe problems require frequent assessment and reassurance by the obstetrician and cardiologist, who should work as a team. Therapy consists of curtailing physical activity, avoiding excessive weight gain, reducing salt intake, immediate treatment of infection, diuresis for fluid -retention, and close observation for signs or symptoms of latent congestive heart failure. Induction of labor and cesarean s~ction are indicated only for obstetrical reasons and not for cardiac reasons. Patients with uncorrected cyanotic CHD or Eisenmenger's syndrome constitute a high-risk group and should be advised against pregnancy._Sterilization is recommended in patients with severe cardiac disability that cannot be controlled with medical or surgical therapy and for whom pregnancy may be life threatening. Cardiovascular surgery during pregnancy is rarely indicated. Prophylactic antibiotics should be employed at