The incidence of clinically significant cardiac disease during pregnancy ranges from 0.1%-4.0%.Heart disease is the most common non-obstetric cause of maternal death, and accounts for 11% of pregnancy related matemal mortality in the USA.Congenital heart disease (CHD) represents 60-80% of cardiac cases.However, acquired heart disease has risen to be the leading cause of maternal death.Pregnancy is associated with substantial changes in the cardiovascular system.