Heart Disease in Pregnancy 2016 (2nd Edition)

Malaysia, with a crude birth rate of 16.9 per 1000 population and an annual population growth rate of 1.3%, has also seen a significant growth in attendances at the Ministry of Health’s antenatal clinics – from 5.7 million in 2013 to 6.1 million in 2014. Allied to the well documented rising prevalence of cardiovascular risk factors in the country over the last two decades, and the improved access of the population to healthcare facilities, it is reasonable to consider that there are greater numbers of pregnant women who are diagnosed or who are at risk of heart disease in Malaysia.

The Clinical Practice Guidelines on the management of heart disease in pregnancy in Malaysia was first published in 2001, so this 2nd edition is timely. These guidelines areintended to be an updated resource which is useful to all clinical practitioners and all those who are involved in the care of pregnant women. It incorporates updated knowledge on heart disease, contemporary diagnostic tools and strategies, and also on treatment options available, now over a decade since the first national guidelines was published on this subject.

The management of pregnant women in heart disease can be complex and often involves a multidisciplinary team, and particularly if the patient newly diagnosed with heart disease at the time of pregnancy. A multidisciplinary team is involved in the care of the pregnant women right through her pregnancy, and even beyond that. In recognition of this, I am proud to see the effort and coordination by the chairperson, Dr Robaayah Zambahari, to assemble an expert panel drawn from various clinical disciplines from different healthcare provider agencies. Their dedication and commitment have resulted in this comprehensive set of guidelines on how to manage heart disease in pregnancy in this modern era. I would like to thank all those who contributed to the publication of these guidelines, which I am certain will be a document often referred to, so that pregnant women with heart disease will be managed optimally to ensure the best possible outcomes for both mother and child.


Datuk Dr. Noor Hisham Bin Abdullah

Director-General of Health Malaysia
Ministry of Health Malaysia


Statement of intent:

This guideline was developed to be a guide for best clinical practice in the management of cardiovascular diseases in pregnancy, based on the best available evidence at the time of development. Specific attempts were made to use local data and publications to ensure local relevance. Adherence to this guideline does not necessarily lead to the best clinical outcome in individual patient care. Every health care provider is responsible for the management of his/her unique patient based on the clinical presentation and management options available locally.

Review of the guideline:

This guideline is issued in 2016 and will be reviewed in about 5 years or earlier if important new evidence becomes available.


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