To the Editor: One of the great privileges in practising obstetric medicine is to support a couple through a successful confinement when they have previously been advised against attempting pregnancy because of pre-existing maternal disease. However, in some cases, pregnancy carries a substantial risk of morbidity and mortality to both the mother and infant. Indeed, many maternal deaths in Australia are still preventable,1 and underlying cardiac disease is an important cause.2
- 1. King JF, Slaytor EK, Sullivan EA. Maternal deaths in Australia, 1997-1999. Med J Aust 2004; 181: 413-414. <MJA full text>
- 2. Sullivan EA, Ford JB, Chambers G, Slaytor EK. Maternal mortality in Australia, 1973–1996. Aust N Z J Obstet Gynaecol 2004; 44: 452-457.
- 3. Morton A. Pregnancy outcome in a mother with alcoholic cardiomyopathy. Aust N Z J Obstet Gynaecol 2005. In press.
- 4. Expert consensus document on management of cardiovascular diseases during pregnancy. Eur Heart J 2003; 24: 761-781.
- 5. Sivaraman P. Management of pregnancy in transplant recipients. Transplant Proc 2004; 36: 1999-2000.
- 6. Jones DC, Hayslett JP. Outcome of pregnancy in women with moderate or severe renal insufficiency. N Engl J Med 1996; 335: 226-232.
- 7. Smith M, Cooper GM, Clutton-Brock TH, et al. Five cases of severe cardiac disease in pregnancy: outcomes and costs. Int J Obstet Anesth 2001; 10: 58-63.
- 8. Seymour J. ART, surrogacy and legal parentage: a comparative legislative review. Melbourne: Victorian Law Reform Commission, 2004.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.