A 30-year-old pregnant woman at 22 weeks is diagnosed with Eisenmenger syndrome (VSD with reversed shunt, resting SpO2 84%). Her obstetrician counsels her regarding maternal mortality risk in pregnancy. What is the approximate risk of maternal mortality quoted in international guidelines?

• A 5–10%
• B 15–25%
• C 30–50% ✓
• D 60–80%

Explanation

Eisenmenger syndrome in pregnancy carries one of the highest maternal mortality rates of any cardiac condition at approximately 30–50% (with some historical series reporting up to 50–65%). Pregnancy dramatically worsens pulmonary hypertension due to increased cardiac output, decreased systemic vascular resistance (which increases right-to-left shunt), and the hypercoagulable state (risk of pulmonary embolism). Current guidelines (ESC 2018) classify Eisenmenger syndrome as modified WHO Class IV — pregnancy is contraindicated, and women who are pregnant should be offered termination of pregnancy.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.