Pulmonary regurgitation is mostly seen in patients with congenital heart disease following previous
relief of right ventricular outflow obstruction such as repaired tetralogy of Fallot [30] or previous
pulmonary valvotomy. Patients with severe pulmonary regurgitation who are asymptomatic with
preserved right ventricular systolic function, unobstructed branch pulmonary arteries and no arrhythmias
tolerate pregnancy well. Pre-pregnancy assessment should consider whether the valve
should be replaced prior to pregnancy, or if either right ventricular dysfunction or branch pulmonary
artery obstruction is present, then right heart failure may develop during pregnancy, and intervention
prior to pregnancy should be considered