Congenital heart disease : contraception and management of pregnancy

The number of women with congenital heart disease reaching childbearing age is constantly increasing due to the advances achieved in cardiac surgery during the past decades. The significant physiological haemodynamic changes and adaptations of the cardiovascular system associated with pregnancy, birth and puerperium increases the cardiovascular risk to pregnant women with congenital heart disease. It is therefore necessary not only the awareness of these haemodynamic changes and risks, but also a multidisciplinary approach that involves preconception counseling, choosing the best contraceptive method, close surveillance during pregnancy, delivery and puerperium. The purpose of this article is to review the major risks associated with pregnancy in women with CHD and to provide an indication on the best contraceptive method and cares during pregnancy in these patients.