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BACKGROUNDS- Cardiac disorders are observed in approximately 1% of pregnancies. They accounts for morbidity and mortality rates and post challenges in management. Heart disease are congenital and acquired, with RHD being the most common in developing countries.Risk factors includes race/ ethnicity, advanced age,hypertension and obesity. pre-existing heart disease is preventable,with late refferals increasing adverse outcome. The study aims to investigate the impact of adverse events and interventions, a-nd correlation between these factors with feto-maternal outcome in pregnant women with heart disease. Methods- The study was conducted in collaboration with the department of cardiology at KGMU ,Lucknow. The study was retrospective observational study lasting far 7 years (2018-2024).The sample size was 100 cases with inclusion criteria including antenatal patients aged 18-40 years, those with a history of cardiac disease, congenital cardiac disease,arrythmia, ischemic heart disease or prior cardiac surgery. Exclusion criteria include patient not giving consent or undergoing medical termination of pregnancy. The study will collect basic basic demographic profile. the initial evaluation was categorized into frist trimester, second trimester and third trimester and peripartum. Cardio-vascular disease was categorised into various categories and comorbidities such as gestational diabetes, gestational hypertension,pre-eclampsia and eclampsia was collected. Result- A study of 100 patient with heart disease found 30% experienced adverse events ,mainly heart failure(15%) and arrhythmias(10%)assosiated with 20% preterm deliveries and NNU/NICU admission. Congenital heart disease and cardiomyopathy had the highest complication rates. Timely intervensions, medication adjustment,and monotoring improved maternal and fetal prognosis. Conclusion- The study highlights the high risk of adverse cardiac events in pregnant women with pre-existing heart disease,especially those with congenital heart conditions and cardiomyopathies.It emphasizes the need for early identification, multidisciplnary management anf tailored interventions to improve maternal and fetal outcome. The findings emphasize the importance of comprenensive care protocol for managing heart disease in pregnant women.