Preconception counselling of the patient with systemic ventricular dysfunction

With improvements in paediatric and adult cardiac care there are now large populations of young women with stable but significant left ventricular dysfunction. These women should all have access to expert multi-disciplinary pre-conception counselling as myocardial disease is a leading cause of maternal morbidity and mortality. This paper discussed the data that is available to the team delivering this counselling and also highlights the areas of uncertainty. Risk scoring systems and investigative tools are all discussed and practical suggestions are made regarding the specific issues that need to be raised in comprehensive counselling. The aim of effective counselling is to empower women to make informed decisions about their plans to start a family and to optimise care when a pregnancy occurs.