Mitral valve heart disease during pregnancy is a real risk both for the mother and fetus. This valve lesion can result in severe physical limitations or even death. Because the disease is diagnosed during gestation in up to 50% of cases, the probability of an adverse outcome increases. Clinical management poses a challenge because the hemodynamic changes during pregnancy, childbirth, and postpartum represent unique risks for this group of patients, which could cause clinical decompensation, such as heart failure, arrhythmia, and maternal death.