Pregnancy following open heart surgery having greater risk of adverse effect like bleeding, fetal loss and congenital malformation especially with oral anticoagulants that must be weighed against the risk of intra-cardiac thrombosis following heart valve replacement surgery. Reported common complications during pregnancies with a history of heart surgery are arrhythmia, hyper-coagulability, thromboembolism, thrombosis of prostheses, abortion, premature delivery, intra-uterine fetal death or intrauterine growth retardation etc. Thus pregnancy following open heart surgery is problematic especially following prosthetic valve replacement. However, interestingly most of the cardiac patients can tolerate the stress of normal vaginal delivery! Therefore, health status of pregnant women with a history of open heart surgery should be evaluated at a regular interval of time throughout the period of pregnancy and also after delivery. Routine antenatal follow up and management in a pregnant woman with history of open heart surgery improves pregnancy outcome and there is no contraindication for pregnancy to the patients with good NYHA functional class.
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