CONGENITAL HEART-DISEASE AND PREGNANCY

In Europe and North America, a dramatic fall in the incidence of rheum atic fever and rheumatic heart disease has coincided with advances in medical and surgical management of congenital heart disease and has re sulted in a shift in the relative incidence of these two categories of cardiac disorders in women of child-bearing age. This review deals wi th pregnancy and congenital heart disease-unoperated and operated. Cen tral to this topic is the intricate interplay between maternal circula tory and respiratory physiology and maternal congenital heart disease, and the effects of this interplay upon the fetus which is exposed to risks that threaten its intrauterine viability and to risks that subse quently express themselves as developmental defects or transmitted con genital malformations of the heart or circulation.