The important feature of a patient with heart disease during pregnancy is the degree of cardiac failure. If this is slight the disease is of little importance. Even with a moderate degree of failure it will be possible for the child to be born if the mother is allowed to take a risk which is not so great as sometimes stated. The first attack of severe decompensation can usually be recovered from with proper treatment, unless the attack should occur during labor. With proper observation and prompt operation severe deeompensat,ion should not occur during labor. Abdominal section is the operation of choice in the emergency, provided a low forceps cannot be done. Ether anesthesia started by chloroform is a better anesthetic for these patients than gas-oxygen. Oxygen inhalations from a mask are helpful to clear up a persistent cyanosis. Without severe cardiac failure or after recovery from it, most patients can be carried through to term or to an induced labor during the eighth month. During labor, watch for a pulse over 95 or respiration over 25 per minute, precordial discomfort, dyspnea, cough, and do not let these little signs become big before putting an end to the labor. In treating lesser grades of failure during pregnancy, the patient must rest enough to spare the heart from overstrain, but this may not necessitate rest in bed for more than a short time. Digitalis should be given in doses sufficient to insure an effect. With this treatment I feel sure it will be possible to diminish the present mortality of about 25 per cent for severe cases and 10 per cent for all cases to a figure which is less disquieting. The important feature of a patient with heart disease during pregnancy is the degree of cardiac failure. If this is slight the disease is of little importance. Even with a moderate degree of failure it will be possible for the child to be born if the mother is allowed to take a risk which is not so great as sometimes stated. The first attack of severe decompensation can usually be recovered from with proper treatment, unless the attack should occur during labor. With proper observation and prompt operation severe deeompensat,ion should not occur during labor. Abdominal section is the operation of choice in the emergency, provided a low forceps cannot be done. Ether anesthesia started by chloroform is a better anesthetic for these patients than gas-oxygen. Oxygen inhalations from a mask are helpful to clear up a persistent cyanosis. Without severe cardiac failure or after recovery from it, most patients can be carried through to term or to an induced labor during the eighth month. During labor, watch for a pulse over 95 or respiration over 25 per minute, precordial discomfort, dyspnea, cough, and do not let these little signs become big before putting an end to the labor. In treating lesser grades of failure during pregnancy, the patient must rest enough to spare the heart from overstrain, but this may not necessitate rest in bed for more than a short time. Digitalis should be given in doses sufficient to insure an effect. With this treatment I feel sure it will be possible to diminish the present mortality of about 25 per cent for severe cases and 10 per cent for all cases to a figure which is less disquieting.