World Health Organization (WHO) has developed a classification scheme for risk from pregnancy in a woman with cardiovascular disease.
Parameters:
(1) risk of maternal mortality
(2) risk of maternal morbidity
Maternal Mortality
Maternal Morbidity
WHO Risk Class
no detectable increase
no or mild increase
I
small increase
moderate increase
II
significant increase
severe increase
III
extremely high risk
extremely high
IV
Conditions that may be classified as Class IV:
(1) pulmonary arterial hypertension
(2) native severe coarctation
(3) LVEF less than 30% with NYHA III or IV
(4) previous peripartum cardiomyopathy with residual impairment of left ventricular function
(5) severe mitral stenosis
(6) severe aortic stenosis
(7) Marfan syndrome with aortic dilation > 45 mm
(8) bicuspid aortic valve with aortic dilatation > 50 mm
Management
normal
evaluate each trimester
expert care required with close monitoring throughout the pregnancy and puerperium
pregnancy contraindicated; consider termination if acceptable; manage a pregnancy as Class III
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Purpose: To evaluate a woman with cardiovascular disease for risks associated with pregnancy using the WHO risk classification.
Specialty: Obstetrics & Gynecology
Objective: risk factors
ICD-10: O10, O16,
