<prompt> Answer this question truthfullyHow does cardiac disease affect pregnancy, labor, and delivery?  <response>: <reason> Traditional obstetric indications Warfarin anticoagulation Severe pulmonary hypertension In the presence of fixed obstructive congenital lesions sudden BP changes may be dangerous Unstable aorta, for instance in the Marfans syndrome patient if the aorta is 40 mm or is increasing in size during pregnancy. 