Pregnancy in congenital heart disease: Risk prediction and counselling
Risk prediction and counselling are the key to limit risks of complications during pregnancy in women with congenital heart disease. The WHO classification and clinical risk tools will guide the physician to the best available risk estimate, but an individualised approach and expert opinion remains paramount in counselling women with congenital heart disease with a pregnancy wish. In women with an estimated low-risk or intermediate-risk pregnancy, planned follow-up and a delivery plan made by a multidisciplinary team provides the best chance of an uncomplicated pregnancy. While the majority do well, there is a small group of women that need an explicit advice not to embark pregnancy, to prevent devastating situations.