With recent advances in prenatal care, the incidence of direct causes of maternal death has declined and indirect causes have gained significant importance. Thromboembolism, hypertension and cardiovascular diseases are the most common indirect causes of maternal death. Acute myocardial infarction, stroke, venous thromboembolism, peripartum cardiomyopathy aortic dissection and amniotic fluid emboli are responsible for the majority of the maternal deaths from cardiovascular causes. The issue of pregnancy of heart transplant--and Turner syndrome--patients requires extensive research. Obstetricians should possess good knowledge of cardiovascular complications of pregnancy because a high index of suspicion and early diagnosis, together with timely and appropriate interventions may save the life of the fetus and the mother.