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Despite advances in the treatment of pulmonary hypertension and improvements in obstetric care, pulmonary hypertension (PH) remains a leading cause of cardiac maternal death in the developed world. The last three decades have seen the development of effective therapies for specific forms of PH, improving patients’ symptoms and more than doubling survival in some forms of PH. Consequently there are an increasing number of women of childbearing potential with PH. Women may present for the first time, with PH in pregnancy, in the early post-partum period or patients with PH may consider pregnancy despite counselling regarding the high risks.