<prompt> Patients with organic hea disease in pregnancy most commonly die during20-24 weeks of pregnancyFirst stage of labourSoon following deliveryTwo weeks postpaum  <response>: Maternal moality in Hea disease complicatin Pregnancy Maternal moality is lowest with rheumatic hea lesions and acyanotic group of hea diseases ie 1 With the elevation of pulmonary vascular resistance especially with cyanotic hea diseases the moality may be raised to 50 Eisenmengers syndrome Most of the deaths occur due to cardiac failure and maximum deaths occurs following bih. Management Of Cardiac Failure: The principle if management is same as in the non-pregnant women. A cardiologist should be involved Propped up position O2 Adminstration Monitoring with ECG and pulse oximetry Diuretic: Frusemide 40-80mg IV - Anticipatory aggresive diuresis is needed to avoid pulmonary congestion. Mechanical Ventilation Injection morphine 15mg IM Digoxin 0.5mg IM followed by Tab.Digoxin 0.25mg PO Dysrhythmias -Quinidine or electrica cardiaversion Tachyarhymias -Adenosine3-12mg IV or DC conversion. Reference: D.C.Duttas Textbook of Obstetrics; 9th edition; Page no: 258 260 