In this section, you will find clinical information (guidelines, protocols and toolkits) relevant to Pregnancy.

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Cardiac antenatal clinic

Pregnancy places a unique stress upon the heart and women with cardiac disease require specialist advice regarding family planning, and specialist supervision throughout pregnancy, delivery and post-partum.

Because of the increasing number of women of child-bearing age with congenital heart disease (CHD) entering adulthood there are now increasing numbers of patients with CHD becoming pregnant. Two-thirds of patients seen in the Bristol antenatal clinic have CHD and managing the interaction between their often complex hearts and the changes during pregnancy and childbirth is challenging. The service also sees women with acquired heart disease and inherited cardiac conditions.

The Royal College of Obstetricians and Gynaecologists (RCOG), European Society of Cardiology (ESC) and MBRRACE-UK: Mothers and Babies: Reducing Risk through Audits and Confidential Enquiries across the UK recommend that pregnant women with heart disease are seen in joint clinics, where each patient is reviewed by a multi-disciplinary team consisting of an obstetrician, cardiologist, anaesthetist and midwife. In Bristol, this Gold standard model of care is provided. The service sees patients from all over the South West in an all-day twice-monthly clinic in St Michaels Hospital in the Antenatal Clinic on Level E. Here women can have consultations with all specialists, see a midwife and have investigations, such as ECG, echo and fetal ultrasound. Before each clinic starts there is a formal multi-disciplinary meeting where upcoming deliveries and birth plans are discussed, as well as high risk patients. A delivery plan is formulated and is filed electronically, in the mother's delivery notes and on the Central Delivery Suite.


The information is listed in alphabetical order. 

Aortopathy in pregnancy guideline (revised Nov 2020)

Cardiac Alert Card

Complex EP cases in pregnancy guideline

Cardiac disease (including endocarditis prophylaxis) - Intrapartum care guideline

Good Practice - Cardiac Disease and Pregnancy (Royal College of Obstetricians and Gynaecologists)

Heart Disease and Pregnancy

Pregnancy Guidelines ESC (2018)

Regional referral pathway for pregnant women with known cardiac disease 

Resources for obstetricians for women with CHD who are pregnant - SV, 2020

UHBristol referral pathway for cardiac problems presenting in pregnancy

UHBristol referral pathway for pre-existing cardiac disease in pregnancy



Leaflets from the Somerville Foundation

Contraception for Women with A Heart Disease

GUCH and Pregnancy (The Somerville Foundation)