What is the meaning of an LVEF less than 30% during pregnancy?

An LVEF (Left Ventricular Ejection Fraction) of less than 30% during pregnancy is indicative of a significant decrease in cardiac function. This level of LVEF is commonly associated with severe heart failure, which is classified as a risk class IV condition according to the American College of Cardiology/American Heart Association (ACC/AHA) classification system for pregnancy and cardiac disease.

In this context, a risk class IV condition indicates that the mother has severe cardiac disease, which is associated with substantial morbidity and mortality both for the mother and the fetus. Pregnant individuals with such a low LVEF are at high risk for developing complications such as pulmonary edema, exacerbation of heart failure, arrhythmias, and increased mortality.

This condition requires careful monitoring and management within a specialized healthcare setting to optimize outcomes for both the mother and the fetus, often involving a multidisciplinary team. Therefore, the indication of a risk class IV condition is vital for both prenatal management and planning for delivery.