Chronic diseases and pregnancy. Effects on mother and child

Pregnancies in women with preexisting disorders are on the increase. The care of these women requires expertise and interdisciplinary teamwork. Knowledge of pregnancy-associated changes are the key for evaluation and treatment. Unplanned pregnancies should be avoided and preconception counselling offered. A stable course of disease for at least six months is recommended before conception. Heart diseases are the leading cause of maternal mortality; symptoms of cardiac dysfunction are often misinterpreted. Women with chronic kidney disease are at risk of loss of renal function and may require preterm delivery. Women with epilepsy are at increased risk, the majority of complications are associated with seizures. In women with chronic diseases, the mode of delivery is usually determined by obstetric criteria.