Abstract

Heart disease remains the major nonobstetric cause of maternal death. Changes in maternal physiology, particularly an increase in cardiac output and a decrease in peripheral vascular resistance, result in a major hemodynamic burden for pregnant patients with organic cardiac lesions. An understanding of these changes is essential to properly evaluate physical findings in pregnant patients and to manage patients with organic heart disease who become pregnant. The indications for prophylaxis against bacterial endocarditis, the use of anticoagulation, and the timing of surgical intervention when necessary are critical considerations.