Congenital heart disease occurs in 0.8% of newborn infants around the world. Advances in medical and surgical treatments over the past decades has led to more than 85% of these infants surviving to adulthood.1 2 Most interventions, however, have not been curative and about half of adults with congenital heart disease face the prospect of further surgery, arrhythmia, heart failure, and—if managed inappropriately—premature death. The burden of pregnancy represents a new challenge in women with congenital heart disease.

In the United Kingdom about 250 000 adults have congenital heart disease (also known as “grown up congenital heart disease (GUCH)” patients), and this number is growing.3 Half of these patients are women, most of reproductive age. After suicide, cardiac disease is now the leading cause of maternal death in the UK, with most of these casualties having had congenital heart disease.4 The medical profession should therefore be aware of the risks that women with congenital heart disease face during pregnancy so that they can be given adequate preconception counselling and optimal care during pregnancy, delivery, and the postpartum period.5^–7