The outlook for patients born with congenital heart disease has transformed over the last three
decades, and now around 85% will survive into adulthood even with complex conditions. Therefore,
there are now many women with congenital heart disease of childbearing age. There is a large
spectrum of conditions ranging from simple lesions with normal life expectancy to complex lifelimiting
conditions associated with significant morbidity. The maternal and foetal risks associated
with pregnancy are therefore varied, and they require careful individual assessment. All women of
childbearing age should have access to advice on contraception and pregnancy at their routine
outpatient visits. These discussions should start, in an age-sensitive manner, during the teenage years.
Some lesions may present for the first time during pregnancy, and some patients may be lost to
routine cardiology follow-up and present again when they fall pregnant. Maternal mortality from
cardiac causes in this population is falling, and this is likely to be a reflection of good pre-pregnancy
counselling and joint antenatal management. It is therefore important that women with congenital
heart disease who are considering pregnancy or are pregnant are encouraged to engage with medical
services.