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Table 2 Modified WHO classification of maternal cardiovascular risk: principles (ESC 2011)

From: Management of pregnant and postnatal women with pre-existing diabetes or cardiac disease using multi-disciplinary team models of care: a systematic review

Risk class Risk of pregnancy by medical condition
I No detectable increased risk of maternal mortality and no/mild increase in morbidity.
II Small increased risk of maternal mortality or moderate increase in morbidity.
III Significantly increased risk of maternal mortality or severe morbidity. Expert counselling required. If pregnancy is decided upon, intensive specialist cardiac and obstetric monitoring needed throughout pregnancy, childbirth, and the puerperium.
IV Extremely high risk of maternal mortality or severe morbidity; pregnancy contraindicated. If pregnancy occurs termination should be discussed. If pregnancy continues, care as for class III.