Abstract:

Pregnancy complicated with heart disease, as a common obstetric complication, has become the leading cause of non-obstetric maternal mortality in China. Physiological changes such as hemodynamics alterations during pregnancy can significantly increase the cardiac load, induce the clinical manifestations of latent cardiac diseases or promote the progression of pre-existing cardiac disease, leading to severe cardiovascular events such as heart failure. Meanwhile, it significantly increases the risk of neonatal events such as preterm birth and small for gestational age infant. An ideal clinical management strategy should be based on a comprehensive preconception assessment, and an individualized treatment plan should be formulated through multidisciplinary collaboration to balance maternal therapeutic needs and fetal safety. In recent years, although there have been continuous advancements in the maternal cardiac risk assessment system, the research on predicting neonatal outcomes is still insufficient. In addition, how to balance maternal and infant safety in clinical decision-making during pregnancy management (e.g., drug or surgical treatment, timing and mode of pregnancy termination) has become a critical issue to be urgently addressed. Combining the latest clinical evidence and international guidelines and consensuses, this article systematically elaborates on the progress of maternal and infant risk assessment and pregnancy management strategies for pregnancy with heart disease, aiming to provide evidence-based medical basis for clinical practice.

Key words: Pregnancy, Heart disease, Risk assessment, Pregnancy outcome, Therapy