Evidence Review
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jun 26, 2025; 17(6): 106295
Published online Jun 26, 2025. doi: 10.4330/wjc.v17.i6.106295
Navigating women with congenital heart disease during pregnancy: Management strategies and future directions
Bibhuti B Das, Varun Aggarwal, Shriprasad R Deshpande
Bibhuti B Das, Congenital Heart Institute, Methodist Children’s Hospital, San Antonio, TX 78229, United States
Varun Aggarwal, Department of Pediatrics, University of Minnesota Medical School, University of Minnesota Medical School, Minneapolis, MN 55454, United States
Shriprasad R Deshpande, Department of Pediatric Cardiology, Children's National Hospital, The George Washington University, Washington, DC 20010, United States
Author contributions: Das BB curated the literature, first draft, revision, and editing; Aggarwal V curated data, edited manuscript, prepared tables; Deshpande SR curated data, edited, and revised the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bibhuti B Das, MD, MBA, MHA, FACC, Congenital Heart Institute, Methodist Children’s Hospital, 7700 Floyd Curl Dr, San Antonio, TX 78229, United States. bbdas001@gmail.com
Received: February 24, 2025
Revised: April 8, 2025
Accepted: May 21, 2025
Published online: June 26, 2025
Processing time: 119 Days and 2.7 Hours
Core Tip

Core Tip: Managing adult congenital heart disease (ACHD) in pregnancy requires a multidisciplinary approach. Preconception counseling, risk stratification with the modified World Health Organization classification, and tailored monitoring optimize maternal and fetal outcomes. Hemodynamic changes can worsen ACHD complications, necessitating specialized cardio-obstetric team care. Individualized delivery plans, vigilant postpartum surveillance, and post-delivery contraception counseling are essential. Advances in imaging and interventions improve outcomes, but high-risk cases demand tertiary center expertise to address cardiac decompensation, arrhythmia, or heart failure, ensuring safe pregnancy management. Future directions emphasize AI-driven risk prediction to further enhance outcomes.