الفهرس 
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Abstract
The incidence of cardiac disease during pregnancy has not changed for decades. The most recent studies report an incidence which ranges between 0.1-4% .
The incidence of rheumatic heart disease is decreasing in the developed countries but remain a problem in the developing countries. On the other hand the incidence of congenital heart disease with pregnancy is increasing in developed countries.
Physiological changes during pregnancy facilitate the adaptation of the cardiovascular system to the increased metabolic needs of the pregnant ladies but these changes may precipitate heart failure in cardiac patients.
Cardiac dieases with pregnancy responsible for ten to15% of maternal mortality but the actual risk depend on the underlying cardiac disease. As well as the risk of death, there is also risk of significant morbidity including endocarditis, arrhythmias.
Fetuses of mothers with cardiac disease may be at increased risk of growth retardation or intrauterine fetal death. Also there is increased risk of congenital heart but depend on maternal cardiac defect. Also many fetal abnormalities are associated with certain medications used by cardiac patients such as warfarin, ACE inhibitor.
preconceptional counseling is of great importance for the woman with heart disease. The antepartum period allows the multidisciplinary medical team time to meet and plan care on the basis of the woman’s ongoing response to pregnancy.
Contraceptive advice is needed from adolescence on words, and the implications of an unplanned pregnancy in an unprepared cardiac patient should be discussed with all young adults with congenital heart disease.