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Background: Complete heart block is a congenital or acquired disorder of cardiac conduction system.Degenerative heart disease is the commonest cause of acquired CHB, which is quite common in this part of country and commonly manifests in elderly males than females and thus uncommonly experienced during gestation.To analyse the feto-maternal outcome.To review the management of CHB during pregnancy.Materials and methods: The observational study was conducted from March 2002 to February 2011 in the department of Obst &Gynae and Cardiology, IPGME&R, Kolkata.Twenty eight pregnancies in 21 women with CHB were included in the study.Results: Mean age of the study population was 24.6 years.Out of 21 cases, 76% presented antenatally.At admission clinical features included fatigability (100%), palpitation (38%), syncope (29%) and dyspnoea (19%).Syncope was observed in four cases during delivery, one on the first day of postpartum and another had in second trimester of pregnancy.Electrocardiography showed CHB in all, with heart rate ranged from 40 to 50 per minute.Echocardiography revealed abnormalities like: Single ventricle in one and Congenitally Corrected Transposition of Great arteries in two cases.Thirty-six percent required temporary pacemaker (TPM) in intrapartum period, 11% had permanent pacemaker (PPM) prior pregnancy and another 11% had PPM implantation during second trimester of pregnancy.All of the five postnatal cases were instituted PPM subsequently.Right internal jugular vein was the site for TPM.Mean gestationaI age at delivery was 38±3weeks.Baby birth weight ranged from 1450 to 3020gm.Eighty six percent pregnancies were delivered by vaginal route.Adverse feto-maternal outcome included 14% fetal growth restriction, 11% preterm labor, 4% syncope related injury, 7% oligohydramnious and 4% postpartum hemorrhage.None had neonatal CHB.Conclusion:Pregnancy outcome was favorable in women with CHB.Cesarean section should be only reserved for obstetric indications.Nineteen percent of pregnancies experienced syncope during or after delivery.PPM during second trimester and TPM during intrapartum period, when indicated, can avoid syncope and may prevent fetal hypoxia due to maternal bradycardia.Multidisciplinary approach with tertiary care back up can achieve successful pregnancy outcome in patients with CHB.