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Pregnancy is associated with substantial cardiocirculatory changes that contribute to greater morbidity and mortality in women with underlying heart disease. An understanding of cardiovascular physiology during pregnancy is vital for proper management of pregnant 63 patients with cardiac disease. Therefore, the diagnosis and management of these disorders in pregnant women require the understanding of cardiovascular physiology during pregnancy, labour and delivery. Only those diagnostic and therapeutic procedures which are considered safe for the fetus should be used during pregnancy. International guidelines help doctors choose appropriate diagnostic and therapeutic procedures and the mode of labour when dealing with pregnant women who also have cardiovascular disease. The guidelines classify pregnant women into low and high risk subgroups.