<prompt> Highest maternal moality is seen in following congenital hea disease:Eisenmengers syndromePulmonary stenosisCoarctation of aoaVSD  <response>: Eisenmengers syndrome is the reversal of a left to right shunt ASD, VSD, PDA due to progressive pulmonary hypeension. Right to left shunting leads to systemic aerial oxygen desaturation and central cyanosis. The degree of cyanosis is determined by the extent of pulmonary vascular obstructive disease. Maternal moality approaches 30-50 and fetal loss may be as high as 75. It is one of the few conditions in which pregnancy is contraindicated. Maternal moality rates average 3 percent in coarctation of aoa. Maternal moality increases in VSD when there is reversal or bidirectional flow--Eisenmenger syndrome. Maternal moality rates approach 10 percent in pulmonic stenosis. Ref: Hameed A.B., Montoro M.N. 2013. Chapter 27. Cardiac Pulmonary Disorders in Pregnancy. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman Eds, CURRENT Diagnosis Treatment: Obstetrics Gynecology, 11e. 