Table Info

Table 1.

Modified WHO classification of maternal cardiovascular risk: application

WHO II-III (depending on individual)-Small increased risk of maternal mortality or moderate increase in morbidity.

• Marfan syndrome without aortic dilatation

• Aorta < 45 mm in aortic disease associated with bicuspid aortic valve

• Repaired coarctation

WHO III-Significantly increased risk of maternal mortality or severe morbidity. Expert counselling required. If pregnancy is decided upon, intensive specialist cardiac and obstetric monitoring needed throughout pregnancy, childbirth, and the puerperium.

• Aortic dilatation 40–45 mm in Marfan syndrome

• Aortic dilatation 45–50 mm in aortic disease associated with bicuspid aortic valve

WHO IV-Extremely high risk of maternal mortality or severe morbidity; pregnancy contraindicated. If pregnancy occurs termination should be discussed. If pregnancy continues, care as for class III.

• Severe systemic ventricular dysfunction (LVEF < 30%, NYHA III–IV)

• Marfan syndrome with aorta dilated > 45 mm

• Aortic dilatation > 50 mm in aortic disease associated with bicuspid aortic valve

• Native severe coarctation

LVEF: left ventricular ejection fraction; NYHA: New York Heart Association; WHO: World Health Organization

Declarations

Author contributions

MI contributed to the conception and design of the study; PR wrote the following sections: Aortopathy in pregnancy, Risk stratification, Pre-conception counselling, Management of pregnancy, Acute aortic syndrome in pregnancy, Conclusions; PG wrote the physiological effect of pregnancy on aorta and the following sections: Introduction, Epidemiology, Timing of aortic surgery in pregnancy, Management during labour, Postpartum management. MI and BV provided overall supervision for this study. All authors contributed to manuscript review, and read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Not applicable.

Consent to publication

Not applicable.

Availability of data and materials

Not applicable.

Funding

Not applicable.

Copyright

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