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
WHO Risk Class |
Management |
---|---|
I |
normal |
II |
evaluate each trimester |
III |
expert care required with close monitoring throughout the pregnancy and puerperium |
IV |
pregnancy contraindicated; consider termination if acceptable; manage a pregnancy as Class III |
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,