Background : Pregnant women with congenital heart disease are at increased risk for cardiac and neonatal complications. Patients and methods : Between January 1991 and December 2004, 45 pregnancies were followed in women with congenital heart disease in our institution. Medical records and echocardiography was reviewed retrospectively. Results : Among 38 women, 45 pregnancies were experienced. Cardiac diagnosis were as follows: ASD 13, VSD 12, AS 4, PDA 3, TOF 1, congenitally corrected TGA 1. 12 patients had pulmonary hypertension. In 7 patients, congenital heart disease was discovered during or after pregnancy. 4 patients underwent therapeutic abortion due to Eisenmenger syndrome. Their NYHA functional class was over III. 4 patients experienced pulmonary edema with worsening functional class during pregnancy and 2 of them died of aggravated heart failure after delivery. There were another 2 maternal deaths in postpartum period. All the four patients had severe pulmonary hypertension with right to left shunt and their NYHA functional class was III. Two of them delivered preterm baby. 17 delivery was cesarian section and 24 was normal vaginal delivery. 4 patients experienced arrhythmia after pregnancy. Mean gestational age was 38.7짹3.0weeks. Mean birth weight was 2963.8짹646.5, Mean 1minute apgar score was 7.6짹1.5, 5 minute apgar score was 8.7짹0.8. There was no neonatal death nor significant complication. Conclusions : Maternal cardiac complication rates are considerable in pregnant women with congenital heart disease. Patients with pulmonary hypertension and NYHA functional class over III are at increased risk for adverse pregnancy outcomes. However, maternal cardiac disease does not influence neonatal outcome significantly.