Table 7 Modified World Health Organization (WHO) classification of maternal cardiovascular risk with maternal cardiac event rate
mWHO I (no risk) | mWHO II (low risk | mWHO II-III (moderate risk) | mWHO III (high risk) | mWHO IV (pregnancy contraindicated) |
|---|---|---|---|---|
Mild | Native/tissue valve disease not WHO I or IV | Mechanical valve | Severe MS Severe symptomatic AS | |
-Pulmonary stenosis | Moderate MS | |||
-Mitral valve prolapse | Severe asymptomatic AS | |||
Repaired simple shunts | Unoperated simple shunts | Mild LV impairment (EF > 45%) HCM | Moderate LV impairment (EF 30–45%) Systemic RV, good/mildly decreased function Recovered PPCM | Severe systemic ventricular dysfunction (EF < 30%/NYHA class III–IV) or > / = moderate if systemic RV PPCM, not recovered |
PDA | Repaired Tetralogy of Fallot | AVSD Repaired coarctation | Fontan Unrepaired cyanotic heart disease/complex heart disease | Fontan with complication Severe (re)coarctation |
Atrial or ventricular ectopic beats | Supraventricular arrhythmias | VT | ||
Turner syndrome, no aortic dilatation | Marfan/HTA, no aortic dilatation Bicuspid aortopathy < 45 mm | Moderate aortic dilatation | Severe aortic dilatation Vascular Ehlers–Danlos | |
PH | ||||
2.5–5% | 5.7–10.5% | 10–19% | 19–27% | 40–100% |