Cardiomyopathy in pregnancy contributes to maternal mortality rates in the United States and is associated with adverse maternal and fetal events.

Pregnancy is associated with significant hemodynamic adaptations that can worsen underlying heart failure or unmask de novo heart failure in women throughout the continuum of pregnancy.

There are key treatment considerations in heart failure management in pregnant women that must balance the maternal benefits of the therapy against the potential fetal risks associated with the therapy.

Counseling and shared decision-making is the cornerstone in the management of heart failure in pregnancy.

A multidisciplinary cardio-obstetrics team should be involved in the care of high-risk birthing individuals early in and throughout pregnancy to optimize maternal and fetal outcomes.