Comments on the guidelines (2018) of the ESC on the management of cardiovascular diseases during pregnancy

Heart diseases in pregnant women are relatively rare; nevertheless, they are the leading cause of pregnancy-associated death in western countries. High blood pressure occurs most frequently with a prevalence of 5–10% and 1–4% of pregnancies are complicated by other maternal cardiovascular diseases. The current guidelines represent recommendations for action for every doctor facing the challenge of advising and treating a pregnant woman with heart disease. This article presents the main topics of risk assessment and consultation before pregnancy for all women of childbearing age with heart diseases. These include women with known congenital heart defects, acquired diseases of the cardiovascular system and the aorta, after surviving a malignant disease and before planned assisted reproductive treatment. Among the experts the benefits of pregnancy heart teams for the care of high-risk patients and for advising the treating physicians were intensively discussed. In other countries these teams are already successful so that the guidelines stipulate the establishment of these teams also in large hospitals in Germany.

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