Table 5.

Risk assessment tools in the parturient with heart disease

Assessment tool	Advantages	Limitations
CARPREG	A prospective study including patients with known heart disease, primarily CHD Identified several independent predictors for the occurrence of an adverse maternal cardiac event during pregnancy	Overrepresentation of complex CHD, thus very high rate of serious complications
ZAHARA	Weighted scoring system for women with CHD, incorporated several other variables	High-risk lesions were underrepresented leading to inaccurate pregnancy risk prediction for sicker patients
Modified WHO cardiac risk assessment	Based on underlying heart disease, presence, and severity of ventricular and valvular dysfunction Pregnancy-related risks are additive, a patient with low-risk cardiac disease may become high risk because of other cardiac/noncardiac risk factors