Context: Due to optimized treatment, there is a rising number of patients with congenital heart disease reaching reproductive age- a challenging situation for obstetricians.Objective: Are symptoms rising during and after pregnancy and is medication needed to be adapted in all groups according to the WHO risk- stratification? Methods: Retrospective analyses of stored data and telefon interviews. Participants: All patients delivering at our clinic with congenital heart disease (n = 27). Two groups were compared according to WHO: group I (WHO I + II, n = 15, low-risk) and group II (WHO III + IV, n = 12, high-risk). Interventions: none. Mean outcome measurement: Symptoms during- and after pregnancy and adaption of medical treatment. Results: There was a significant difference according to age (28,51 ± 4,19 vs. 32,81 ± 4,91, p = 0,047), duration of pregnancy in days (271,27 vs. 247,42, p = 0,002), birthweight (3083,20g vs. 2419,00g, p = 0,007) , APGAR Score 1 minute (8,80 vs. 6,67, p = 0,006) and 5 minutes (9,73 vs. 8,25, p = 0,008), mode of delivery (Cesarean section rate 40% (n=6) vs. 100%, p = 0,001), symptoms during pregnancy (13,3% vs. 58,3%, p = 0,037 ) and adaption of medication during (13,3% vs. 67,7%, p = 0,007) and after (6,7% vs. 67,7%, p = 0,003) pregnancy. There was no difference according to parity, abortions, 10 minutes APGAR score, breastfeeding, medication before- and symptoms before- and after pregnancy. Conclusion: There is information in literature that in general the risk for complications in patients with congenital heart disease is eight fold higher compared with the normal collective. In our data there was a higher rate of symptoms during pregnancy and adaption of medication. In this very heterogenous patients individual treatment seems inevitable- including cardiologists, anesthetists- but it seems achievable.