Which condition is classified as WHO maternal CV risk group II?

Which condition is classified as WHO maternal CV risk group II?

• A. Hypertrophic cardiomyopathy
• B. Complex congenital heart disease
• C. Fontan repair for hypoplastic left heart syndrome
• D. Mechanical heart valve

Answer: (A)

In this WHO classification, some heart conditions carry a small increase in risk during pregnancy (Group II), meaning pregnancy is possible but requires close specialist care and careful monitoring. Hypertrophic cardiomyopathy fits this category when it is uncomplicated—meaning preserved systolic function, no significant LV outflow tract obstruction, and no high-risk arrhythmias. In such cases, the pregnancy risk is present but relatively modest, and with appropriate management (cardiology and maternal–fetal medicine follow-up, and measures to control heart rate and maintain stability), the outcome is generally favorable. If hypertrophic cardiomyopathy does have problematic features—such as LV outflow obstruction, reduced function, or troubling arrhythmias—the risk rises and it would move into a higher WHO category. The other conditions listed usually pose higher risk: Fontan physiology represents a single-ventricle circulation with limited reserve, complex congenital heart disease encompasses a broad range of high-risk lesions, and a mechanical heart valve carries substantial maternal and fetal risks due to anticoagulation and thrombosis potential, often placing them in Group III or IV. So, uncomplicated hypertrophic cardiomyopathy is best aligned with Group II because it can be managed with careful surveillance and therapy, while the others typically require higher-risk classifications.

In this WHO classification, some heart conditions carry a small increase in risk during pregnancy (Group II), meaning pregnancy is possible but requires close specialist care and careful monitoring. Hypertrophic cardiomyopathy fits this category when it is uncomplicated—meaning preserved systolic function, no significant LV outflow tract obstruction, and no high-risk arrhythmias. In such cases, the pregnancy risk is present but relatively modest, and with appropriate management (cardiology and maternal–fetal medicine follow-up, and measures to control heart rate and maintain stability), the outcome is generally favorable.

If hypertrophic cardiomyopathy does have problematic features—such as LV outflow obstruction, reduced function, or troubling arrhythmias—the risk rises and it would move into a higher WHO category. The other conditions listed usually pose higher risk: Fontan physiology represents a single-ventricle circulation with limited reserve, complex congenital heart disease encompasses a broad range of high-risk lesions, and a mechanical heart valve carries substantial maternal and fetal risks due to anticoagulation and thrombosis potential, often placing them in Group III or IV.

So, uncomplicated hypertrophic cardiomyopathy is best aligned with Group II because it can be managed with careful surveillance and therapy, while the others typically require higher-risk classifications.